Provider Demographics
NPI:1821273368
Name:WOMEN'S HEALTH OF MANSFEIDL
Entity Type:Organization
Organization Name:WOMEN'S HEALTH OF MANSFEIDL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHENOA
Authorized Official - Middle Name:
Authorized Official - Last Name:NUTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-473-7172
Mailing Address - Street 1:2800 E BROAD ST
Mailing Address - Street 2:SUITE 308
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-6409
Mailing Address - Country:US
Mailing Address - Phone:817-473-7172
Mailing Address - Fax:817-473-7574
Practice Address - Street 1:2800 E BROAD ST
Practice Address - Street 2:SUITE 308
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-6409
Practice Address - Country:US
Practice Address - Phone:817-473-7172
Practice Address - Fax:817-473-7574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-03
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9544207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty