Most Relevant Information
Provider Data
| NPI Number: | 1003667999 |
| Provider Name: | JEREMY DEMITCHELL FNP-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 1130632 |
Most Important Dates
| Enumeration Date: | 03/28/2024 |
| Last Updated: | 03/28/2024 |
Provider Practice Location
900 8TH AVE
FORT WORTH
TX
761043902
Practice Location Phone/Fax
| Phone: | 8173362100 |
| Fax: |
Provider Mailing Location
321 ALLENWOOD DR
FORT WORTH
TX
761345356
Provider Mailing Phone/Fax
| Phone: | 9064586126 |
| Fax: |