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MISSION HAVEN REDIEMED
NPI 1558062059
Family Medicine in Arlington, TX

Active since March 13, 2023
6108 SHOREWOOD DR, ARLINGTON, TX 76016(817) 435-2812 Get Directions Write a Review

NPPES record last updated: November 27, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mission Haven Rediemed NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MISSION HAVEN REDIEMED (NPI 1558062059) is a healthcare organization registered as a family medicine in Arlington, Texas and active in the NPI registry since March 2023. The organization maintains a secondary practice location in Arlington and lists Abi Mikkel Provence, Owner And Provider, as its authorized official.

NPPES Registry Identity

NPI1558062059
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMISSION HAVEN REDIEMED
Location Address6108 SHOREWOOD DRArlington, TX 76016-2649
Mailing AddressPo Box 170428Arlington, TX 76003-0428 · (817) 435-2812 · Fax (817) 719-9236
Phone(817) 435-2812
Organization SubpartNo
Authorized OfficialAbi Mikkel ProvenceOwner And Provider · (817) 992-9791
Enumeration DateMarch 13, 2023
Last NPPES UpdateNovember 27, 2023
NPPES CertifiedNovember 27, 2023
✔ NPI 1558062059 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X
Also ListedClinic/Center · Urgent CareTaxonomy 261QU0200X
6108 SHOREWOOD DR, Arlington, TX 76016
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Secondary Practice Location 1

Location 12117 Brentgate DrArlington, TX 76017-1611 · Phone (817) 435-2812 · Fax (817) 719-9236

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ABI MIKKEL PROVENCE MSN, FNP-BC & FNP-C
Nurse Practitioner (Primary Care)
6108 SHOREWOOD DR
ARLINGTON, TX 76016
Tarrant County (817) 435-2812

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mission Haven Rediemed's NPI number?

The NPI number for Mission Haven Rediemed is 1558062059. It was assigned to this organization in the NPPES registry on March 13, 2023.

Where is Mission Haven Rediemed located?

Mission Haven Rediemed is located at 6108 Shorewood Dr, Arlington, TX 76016. The listed phone number is (817) 435-2812.

What is Mission Haven Rediemed's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Mission Haven Rediemed was last updated on November 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.