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1417661588
LATASHA CROCKETT
FORT WORTH, TX
NPI
1417661588
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LA2100X Nurse Practitioner Acute Care
(Licence: TX 1091068)
Enumeration Date
2023-01-12
Last Update Date
2024-04-23
Business Address
LATASHA CROCKETT
6000 WESTERN PL STE 900
FORT WORTH, TX 76107-4691
Phone number: 817-740-8400
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Mailing Address
LATASHA CROCKETT
5020 CHISHOLM VIEW DR
FORT WORTH, TX 76123-1575
Phone number: 254-413-3157
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