Individual
MELISSA MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 8TH AVE, FORT WORTH, TX 76104-4110
(817) 926-2544
Mailing address
6225 N STATE HIGHWAY 161 STE 200, IRVING, TX 75038-2241
(214) 687-0001
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
812983
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
1010768
TX
Other
Enumeration date
03/22/2020
Last updated
08/25/2020
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