Individual provider · NPI-1

Deepa Tony Abraham

Nurse Practitioner, Family · Fort Worth, TX

NPI number1760927172
StatusActive
Last updated in NPPESMar 17, 2018

Details

NPI
1760927172
Entity type
Individual (NPI-1)
Name
Deepa Tony Abraham
Sex
Female
Sole proprietor
Yes
Enumeration date
Dec 21, 2016
Last updated
Mar 17, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, FamilyAP133659TXYes
163W00000X Registered Nurse95153OK

Other names

  • Deepa Kochethu (Former Name)

Practice location

609 Hemphill St
Fort Worth, TX 76104-3149

Phone 817-923-8484

Mailing address

10416 Hollyhead Way
Yukon, OK 73099-7517

Phone 405-371-8891

Other practice locations

10416 Hollyhead Way
Yukon, OK 73099-7517

Phone 405-371-8891

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Nurse Practitioner, Family providers in Fort Worth, TX