Provider Demographics
NPI:1487667747
Name:MEANS, CONNIE DYWEECE (MSN, RN)
Entity Type:Individual
Prefix:MRS
First Name:CONNIE
Middle Name:DYWEECE
Last Name:MEANS
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6000 WESTERN PL
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-4607
Mailing Address - Country:US
Mailing Address - Phone:817-570-2230
Mailing Address - Fax:817-570-2231
Practice Address - Street 1:6000 WESTERN PL
Practice Address - Street 2:SUITE 300
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-4607
Practice Address - Country:US
Practice Address - Phone:817-570-2230
Practice Address - Fax:817-570-2231
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX236760163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health