Provider Demographics
NPI:1700324761
Name:TRUE CONNECTIONS PEDIATRICS
Entity Type:Organization
Organization Name:TRUE CONNECTIONS PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELISHIA
Authorized Official - Middle Name:LANNETTE
Authorized Official - Last Name:FEATHERSTON
Authorized Official - Suffix:
Authorized Official - Credentials:DNP,APRN, CPNP-PC
Authorized Official - Phone:469-363-7982
Mailing Address - Street 1:323 WESTPARK WAY
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76040-3902
Mailing Address - Country:US
Mailing Address - Phone:682-253-5437
Mailing Address - Fax:
Practice Address - Street 1:323 WESTPARK WAY
Practice Address - Street 2:
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76040-3902
Practice Address - Country:US
Practice Address - Phone:682-253-5437
Practice Address - Fax:817-210-4957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-09
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX372027801Medicaid