Individual
ABI MIKKEL PROVENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, FNP-BC & FNP-C
Contact information
Practice address
6108 SHOREWOOD DR, ARLINGTON, TX 76016-2649
(817) 435-2812
Mailing address
PO BOX 170428, ARLINGTON, TX 76003-0428
(817) 729-7853
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
AP138443
TX
Other
Enumeration date
08/11/2018
Last updated
11/27/2023
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