Most Relevant Information
Provider Data
| NPI Number: | 1003289935 |
| Provider Name: | CRYSTAL RENE ROSE CNM |
| Entity Type: | Individual |
| Taxonomy Code: | 367A00000X |
| Specialty: | Advanced Practice Midwife |
| License Number: | AP128269 |
Most Important Dates
| Enumeration Date: | 10/30/2015 |
| Last Updated: | 02/09/2022 |
Provider Practice Location
7016 BRYANT IRVIN RD STE 100
FORT WORTH
TX
761324120
Practice Location Phone/Fax
| Phone: | 8173778820 |
| Fax: | 8173778450 |
Provider Mailing Location
7016 BRYANT IRVIN RD STE 100
FORT WORTH
TX
761324120
Provider Mailing Phone/Fax
| Phone: | 8173778820 |
| Fax: | 8173778450 |