Individual
CHINNAPA R GADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1001 PENNSYLVANIA AVE, FORT WORTH, TX 76104-2228
(817) 877-5858
(817) 335-4418
Mailing address
1000 W CANNON ST, FORT WORTH, TX 76104-3029
(817) 725-7900
(682) 207-1030
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041368825
IL
363L00000X
Nurse Practitioner
Primary
AP129918
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041368825
IL DEPARTMENT OF PROFESSIONAL REGULATION
IL
01
—
AP129918
ADVANCED PRACTICE NURSE LICENSE
TX
Enumeration date
09/09/2008
Last updated
09/02/2022
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