Leatherwood, Dana Jean

Leatherwood, Dana Jean is an sole proprietor health care provider with primary practice located at 1301 Pennsylvania Ave , Fort Worth TX 76104-2122. 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. Leatherwood, Dana Jean can be contacted via phone (817) 250-2084.

Contact Information

Primary practice address
1301 Pennsylvania Ave Fort Worth TX 76104-2122
Phone: (817) 250-2084
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 547178 Texas

Profile Details

NPI number 1023203726
LBN Legal business name Leatherwood, Dana Jean
Credentials PMHNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 6th, 2007
Last updated Nov 18th, 2008 - about 18 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 1023203726 NPPES
Texas Other 8Y3083 BLUE CROSS BLUE SHIELD

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