Dispo, Joanne

Dispo, Joanne is an sole proprietor health care provider with primary practice located at 601 W Terrell Ave , Fort Worth TX 76104-3243. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Dispo, Joanne can be contacted via phone (817) 702-3100.

Contact Information

Primary practice address
601 W Terrell Ave Fort Worth TX 76104-3243
Phone: (817) 702-3100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 730584 Texas

Profile Details

NPI number 1477981702
LBN Legal business name Dispo, Joanne
Credentials APRN-PMHNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 23rd, 2013
Last updated Apr 28th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477981702 NPPES
Texas Other 8177NF BLUE CROSS BLUE SHIELD
Texas Other 331002102 BLUE CROSS BLUE SHIELD
Texas MEDICAID 331002101 BLUE CROSS BLUE SHIELD

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