| Healthy Haven Healthcare | |
|
5833 Sycamore Creek Rd Fort Worth TX 76134-1918 | |
| (863) 528-5627 | |
| (888) 752-9156 |
| Full Name | Healthy Haven Healthcare |
|---|---|
| Speciality | Family Medicine |
| Location | 5833 Sycamore Creek Rd, Fort Worth, Texas |
| Authorized Official Name and Position | Kimberly N Scott (OWNER) |
| Authorized Official Contact | 8635285627 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthy Haven Healthcare 201 Southview Dr Hudson Oaks TX 76087-8232 Ph: (863) 528-5627 | Healthy Haven Healthcare 5833 Sycamore Creek Rd Fort Worth TX 76134-1918 Ph: (863) 528-5627 |
| NPI Number | 1891478996 |
|---|---|
| Provider Enumeration Date | 08/08/2023 |
| Last Update Date | 08/08/2023 |
| Medicare PECOS PAC ID | 6204289424 |
|---|---|
| Medicare Enrollment ID | O20240124001955 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891478996 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Kimberly Nichole Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336779941 PECOS PAC ID: 0547663403 Enrollment ID: I20210729001979 |
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