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1164855078
STEPHANIE LARGE
FORT WORTH, TX
NPI
1164855078
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: TX 836232)
Enumeration Date
2013-08-14
Last Update Date
2017-11-10
Business Address
-- STEPHANIE LARGE NP
855 MONTGOMERY ST
FORT WORTH, TX 76107-2553
Phone number: 817-735-2660
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Mailing Address
-- STEPHANIE LARGE NP
855 MONTGOMERY ST
FORT WORTH, TX 76107-2553
Phone number: 817-735-5058
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