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1922204486
PHYLLIS A WAKELAND
FORT WORTH, TX
NPI
1922204486
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: TX 514228)
Enumeration Date
2007-06-22
Last Update Date
2016-08-31
Business Address
-- PHYLLIS A WAKELAND PNP
1500 COOPER ST
FORT WORTH, TX 76104-2710
Phone number: 682-885-7960
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Mailing Address
-- PHYLLIS A WAKELAND PNP
PO BOX 99371
FORT WORTH, TX 76199-0371
Phone number: 682-885-1855
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