Provider Demographics
NPI:1275172900
Name:CARRUTH, FIONA GHOSH (CPNP-PC)
Entity Type:Individual
Prefix:MRS
First Name:FIONA
Middle Name:GHOSH
Last Name:CARRUTH
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2106 GREEN HILL DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75072-5462
Mailing Address - Country:US
Mailing Address - Phone:214-726-2663
Mailing Address - Fax:
Practice Address - Street 1:6300 STONEWOOD DR STE 206
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-5281
Practice Address - Country:US
Practice Address - Phone:972-769-8700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-28
Last Update Date:2019-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143808363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics