Provider Demographics
NPI:1427688209
Name:JARVIS, BREANN LASHAE (APRN, FNP-C)
Entity type:Individual
Prefix:MS
First Name:BREANN
Middle Name:LASHAE
Last Name:JARVIS
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 COUNTY ROAD 4898
Mailing Address - Street 2:
Mailing Address - City:SPRINGTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:76082-3865
Mailing Address - Country:US
Mailing Address - Phone:817-791-6557
Mailing Address - Fax:
Practice Address - Street 1:4504 BOAT CLUB RD STE 800
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76135-7002
Practice Address - Country:US
Practice Address - Phone:817-237-0515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP144566363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily