Provider Demographics
NPI:1861102733
Name:RAHN DE VU, BRITTANI (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:BRITTANI
Middle Name:
Last Name:RAHN DE VU
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1617 W OLEANDER ST STE A
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-4024
Mailing Address - Country:US
Mailing Address - Phone:817-923-9788
Mailing Address - Fax:817-921-0070
Practice Address - Street 1:1617 W OLEANDER ST STE A
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4024
Practice Address - Country:US
Practice Address - Phone:817-923-9788
Practice Address - Fax:817-921-0070
Is Sole Proprietor?:No
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1099439363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health