MRS. DANA JEAN LEATHERWOOD PMHNP NPI 1023203726

NPI Information

NPI: 1023203726
Provider Name: MRS. DANA JEAN LEATHERWOOD, PMHNP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
1301 PENNSYLVANIA AVE
FORT WORTH, TX
ZIP 76104
Phone: (817) 250-2084
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MRS. Dana Jean Leatherwood, PMHNP is a psychiatric/mental health nurse practitioner in Fort Worth, TX. MRS. Dana Jean Leatherwood, PMHNP NPI is 1023203726. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1301 PENNSYLVANIA AVE
FORT WORTH, TX
ZIP 76104-122
Phone: (817) 250-2084

The NPI 1023203726 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 9/6/2007 and was last updated on 11/18/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	547178	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	8K5688	MEDICARE PIN	TEXAS
2	8Y3083	OTHER	TEXAS	BLUE CROSS BLUE SHIELD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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