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1093305401
LYNN IDELL MOGENSEN
FORT WORTH, TX
NPI
1093305401
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Former Name
LYNN IDELL LATOUR
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: TX 1025471)
Enumeration Date
2021-01-20
Last Update Date
2021-01-20
Business Address
LYNN IDELL MOGENSEN FNP
2004 NOTTINGHAM BLVD
FORT WORTH, TX 76112-5229
Phone number: 530-949-1291
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Mailing Address
LYNN IDELL MOGENSEN FNP
2004 NOTTINGHAM BLVD
FORT WORTH, TX 76112-5229
Phone number: 530-949-1291
Copy
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