Individual provider · Type 1 NPI

Mary Carol Kistner, CPNP

Primary Care Nurse Practitioner · Fort Worth, TX

NPI number 1174787345 Active

Practice location

1401 W Pulaski St
Fort Worth, TX 76104-2717

Fax (682) 885-8014

Mailing address

PO Box 99213
Fort Worth, TX 76199-0213

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse 163W00000X505410 (TX)
Pediatric Nurse Practitioner 363LP0200XAP117015 (TX)
Primary Care Nurse Practitioner Primary 363LP2300XAP117015 (TX)

Primary Care Nurse Practitioner: Definition to come...

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About NPI 1174787345

Mary Carol Kistner, CPNP's National Provider Identifier is 1174787345, issued on Jul 16, 2008. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Fort Worth, TX. The record was last updated on Jul 3, 2024.