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1225421654
CARRA MICHELLE DEDUSEVIC
FORT WORTH, TX
NPI
1225421654
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Former Name
CARRA MICHELLE TEADT
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: TX AP127513)
Enumeration Date
2015-03-10
Last Update Date
2015-03-10
Business Address
-- CARRA MICHELLE DEDUSEVIC APRN
1350 S MAIN ST STE 3300
FORT WORTH, TX 76104-7655
Phone number: 817-702-4925
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Mailing Address
-- CARRA MICHELLE DEDUSEVIC APRN
1617 HEMPHILL ST
FORT WORTH, TX 76104-4709
Phone number:
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