Provider Demographics
NPI:1033467477
Name:STEVENS, RHODA GWAN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:RHODA
Middle Name:GWAN
Last Name:STEVENS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:RHODA
Other - Middle Name:ASHIE
Other - Last Name:GWAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, FNP-BC
Mailing Address - Street 1:6080 S HULEN STREET, STE 360
Mailing Address - Street 2:PMB 198
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-4810
Mailing Address - Country:US
Mailing Address - Phone:817-612-1551
Mailing Address - Fax:817-720-9989
Practice Address - Street 1:6801 MCCART AVE STE 109
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76133-6378
Practice Address - Country:US
Practice Address - Phone:817-612-1551
Practice Address - Fax:817-720-9989
Is Sole Proprietor?:No
Enumeration Date:2012-08-15
Last Update Date:2023-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX822684363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily