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Ida Madoka Lightfoot, RN,PMHNP
Psychiatric/Mental Health Nurse Practitioner in Plano, Texas
NPI 1851397046

Ida Madoka Lightfoot is a Psychiatric/Mental Health Nurse Practitioner based in Weatherford, TX and is specialized in Psychiatric/Mental Health. Ida Madoka Lightfoot practices in Plano, TX and has the professional credentials of RN,PMHNP. The NPI Number for Ida Madoka Lightfoot is 1851397046 and holds a License No. 593409 (Texas).

The current practice location address for Ida Madoka Lightfoot is 6404 International Pkwy Ste 1010, Plano, TX and can be reached out via phone at 972-267-1988. You can also correspond with Ida Madoka Lightfoot through the mailing address at 1241 FOREST PARK DR, WEATHERFORD, TX - 76087-2805 (mailing address contact number: 817-821-9978).

Location: 6404 International Pkwy Ste 1010, Plano, TX, 76087-2805
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Provider Profile Details
NPI Number
1851397046
Provider Name
Ida Madoka Lightfoot
Credential
RN,PMHNP
Provider Entity Type
Individual
Gender
Female
Address
6404 International Pkwy Ste 1010, Plano, TX, 76087-2805
Phone Number
972-267-1988
Fax Number
Provider Enumeration Date
06/22/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
368676801 05 TX
P94062 01 TX MEDICARE UPIN
institution
Provider Business Practice Location Address Details
Address
6404 International Pkwy Ste 1010
City
State
Zip
75093-8346
Phone Number
972-267-1988
Fax Number
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Provider Business Mailing Address Details
Address
1241 Forest Park Dr
City
State
Zip
76087-2805
Phone Number
817-821-9978
Fax Number
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Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
License No.
593409 (Texas)
Definition
Definition to come...
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