DR. TAWANDA NITCHELLE BOSTIC (NPI# 1154576197) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154576197 |
| Entity Type | Individual |
| Full Name | DR. TAWANDA NITCHELLE BOSTIC |
| Credential | FNP-BC/PMHNP-BC |
| Practice Address |
6000 Western Pl Fort Worth TX 76107-4607 |
| Mailing Address |
9805 Statesville Rd Ste 6331 Charlotte NC 28269-7647 |
| Practice Telephone | 7046417475 |
| Mailing Telephone | 7046417475 |
| Mailing Fax Number | 7049929546 |
| Enumeration Date | 2008-11-18 |
| Last Update Date | 2020-09-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WM0705X |
Registered Nurse Specialization: Medical-Surgical |
196483 | NC | Nursing Service Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
APRN-LIC-127603 | MT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
196483 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
AP60975928 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
196483 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | NCBON- RN LICENSE | 196483 | 01 |
| NC | ANCC- FNP CERTIFICATION | 2008006354 | 01 |
| NC | ANCC | 2013020566 | 01 |
| MT | MONTANA APRN LICENSE | APRN-LIC-127603 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 10150 Mallard Creek Rd, Suite 101, Charlotte, NC 282103297 | 7045102662 |
| Street Address |
6000 WESTERN PL |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76107-4607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063449064 | Linda Lorena Sands | Nurse Anesthetist, Certified Registered | 6000 Western Pl, Fort Worth, TX 76107-4660 | 2006-06-26 |
| 1265751622 | Home Sweet Homehealth, LLC | Hospice Care, Community Based | 6000 Western Pl, Suite 710, Fort Worth, TX 76107-4607 | 2010-05-25 |
| 1841463312 | Doreen Krodel | Social Worker | 6000 Western Pl, Suite 300, Fort Worth, TX 76107-4607 | 2008-04-07 |
| 1265615827 | Recreation Therapy Service | Clinic/Center | 6000 Western Pl, 300, Fort Worth, TX 76107-4607 | 2007-12-06 |
| 1114112562 | Susan Brown Avery | Social Worker | 6000 Western Pl, Suite 300, Fort Worth, TX 76107-4607 | 2007-09-10 |
| 1487667747 | Connie Dyweece Means | Registered Nurse | 6000 Western Pl, Suite 300, Fort Worth, TX 76107-4607 | 2006-08-15 |
| 1871501080 | Michael Tedford Lambert | Psychiatry & Neurology | 6000 Western Pl, Suite 300, Fort Worth, TX 76107-4607 | 2006-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629683602 | Renovo Wound and Hyperbarics Pllc | Emergency Medicine | 5668 Edwards Ranch Road, Suite 101, Fort Worth, TX 76107 | 2020-09-15 |
| 1669085437 | Ryan Bourgeois | Nurse Practitioner | 2917 Crocket Street, Fort Worth, TX 76107 | 2020-08-31 |
| 1053920546 | Christa Marie Widjaja | Optometrist | 1700 Montgomery St, Fort Worth, TX 76107 | 2020-07-30 |
| 1093351355 | Raymond Iannone | Pharmacist | 850 Montgomery St, Suite #310, Fort Worth, TX 76107 | 2019-11-21 |
| 1053963744 | Cumulus Injury Resolution, Inc. | Chiropractor | 4936 Byers Avenue, Fort Worth, TX 76107 | 2019-07-12 |
| 1770135576 | Shadia Osakwe | Physician Assistant | 855 Montgomery Street, Pediatric Clinic, Fort Worth, TX 76107 | 2019-07-11 |
| 1568945442 | Sachin P Patel | Physical Therapist | 4825 Wellesley St, Fort Worth, TX 76107 | 2018-09-07 |
| 1023594025 | Ftw Pharmacy Services Inc | Durable Medical Equipment & Medical Supplies | 2912 W 6th St Ste 150, Fort Worth, TX 76107 | 2018-07-13 |
| 1669974325 | Helen Williamson Elliott | Counselor | 1751 River Run #217, Fort Worth, TX 76107 | 2018-03-08 |
| 1487156931 | Pelvic Neuromonitoring Pllc | Electrodiagnostic Medicine | 111 Boland St #211, Ft Worth, TX 76107 | 2018-03-01 |
| Find all providers in zip 76107 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386257814 | Daniel Oyewusi Oyewole | Nurse Practitioner | 4051 Hunters Creek Dr, Fort Worth, TX 76123-2549 | 2020-08-25 |
| 1174147037 | Ugbodu Ene Awoniyi | Nurse Practitioner | 4924 Cliburn Dr, Fort Worth, TX 76244-6130 | 2020-06-05 |
| 1346863925 | Lynnetta Vanice Cheeks | Nurse Practitioner | 6101 Saddlepack Dr, Fort Worth, TX 76123-1591 | 2020-05-18 |
| 1073143160 | Dorcas Mwangi | Nurse Practitioner | 4809 Campfire Ct, Fort Worth, TX 76244-7922 | 2020-01-17 |
| 1497390686 | Chigane Abraham | Nurse Practitioner | 8609 Glenburne Dr, Fort Worth, TX 76131 | 2019-11-12 |
| 1457895666 | Paul Geise | Nurse Practitioner | 3501 Ne Loop 820, #306, Fort Worth, TX 76137-2415 | 2016-12-06 |
| 1477005007 | Amie Wolverton Riddle | Nurse Practitioner | 320 Silver Canyon Dr, Fort Worth, TX 76108-9612 | 2016-10-31 |
| 1659742211 | Kamesha Roshun Mitchell | Nurse Practitioner | 3100 Hulen St, Fort Worth, TX 76107 | 2015-10-08 |
| 1255592424 | Akosua Serwaa Obeng | Nurse Practitioner | 8949 Silent Brook Ln, Fort Worth, Fort Worth, TX 76244-4946 | 2008-06-20 |
| 1154518470 | Dawn Dean | Nurse Practitioner | 124 Cooks Ln, Fort Worth, TX 76120-2016 | 2007-10-01 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76107 |
Please comment or provide details below to improve the information on DR. TAWANDA NITCHELLE BOSTIC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.