Provider Demographics
NPI:1730334723
Name:FIELDSMITH, RETA (RN ANP)
Entity type:Individual
Prefix:
First Name:RETA
Middle Name:
Last Name:FIELDSMITH
Suffix:
Gender:F
Credentials:RN ANP
Other - Prefix:
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Mailing Address - Street 1:1001 GLENDA ST
Mailing Address - Street 2:
Mailing Address - City:TERRELL
Mailing Address - State:TX
Mailing Address - Zip Code:75160-5013
Mailing Address - Country:US
Mailing Address - Phone:214-232-3471
Mailing Address - Fax:888-990-2984
Practice Address - Street 1:1001 GLENDA ST
Practice Address - Street 2:
Practice Address - City:TERRELL
Practice Address - State:TX
Practice Address - Zip Code:75160-5013
Practice Address - Country:US
Practice Address - Phone:214-232-3471
Practice Address - Fax:972-563-7395
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-18
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX604243363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health