Provider Demographics
NPI:1023700697
Name:FOX-RABINOVITZ, MISTY N (APRN-CNP)
Entity type:Individual
Prefix:
First Name:MISTY
Middle Name:N
Last Name:FOX-RABINOVITZ
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:282 SHARI DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-2657
Mailing Address - Country:US
Mailing Address - Phone:940-453-2038
Mailing Address - Fax:
Practice Address - Street 1:282 SHARI DR
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-2657
Practice Address - Country:US
Practice Address - Phone:940-453-2038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-23
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1039456363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health