AYMAN AROUSE MD, FAAP Dr. Arouse has been in practice for over 20 years. He received his medical degree from Tishreen University College of Medicine, Lattakia, Syria. He completed his residency in pediatrics at Mercy Hospital in Pittsburgh, Pennsylvania, where he also served an extra year as a chief resident. Dr. Arouse is board-certified through the American Board of Pediatrics and a fellow of the American Academy of Pediatrics. His professional interests include dermatology and mental health. He and his wife share three beautiful children and enjoy sports, traveling, and reading. 
TIM SCIFRES MPAS, PA - C Being a native of the Fort Worth area, Tim got his start in healthcare on the pharmacy side of medicine before turning to patient-centered care. He attended the University of North Texas, where he majored in science and minored in both chemistry and Spanish. Prior to earning a Master of Science degree in Physician’s Assistant Studies from UNT’s Health Sciences Center, Tim served as a Peace Corp volunteer in Peru and speaks Spanish fluently. He also gained experience in orthopedic oncology and pain management before turning his focus to pediatric primary care. Tim has been practicing as a physician’s assistant since 2014, and is licensed by the Texas Medical Board, as well as the NCCPA. 
DARCI LAMONTAGNE MSN, RN, CPNP Before settling in Texas, Darci moved between several states due to being raised in a military family. She received her nursing degree from the University of North Carolina in Chapel Hill and then moved to North Texas in 2007 to pursue higher education at the University of Texas at Arlington. She worked in pediatric dermatology at Children’s Health in Dallas, and after spending ten years there, she considers dermatology her specialty. At First Step Pediatrics, she can treat skin infections (bacterial, fungal, and viral) alongside the usual needs that may bring your child through our doors. She is certified by the Pediatric Nursing Certification Board (PNCB) and has practiced since 2007. 
MICHELLE NARANJO MSN, RN, FNP - C Michelle’s career as a nurse began in her hometown of Corpus Christi, where she attended Del Mar College and received her associate degree in nursing. She would earn her bachelor's and master's degrees from the University of Texas at Arlington, which started her career in primary care. Before joining First Step Pediatrics, Michelle worked in neuro-intensive care, as well as oncology. She is fluent in Spanish and is licensed by both the American Academy of Nurse Practitioners and the Texas Board of Nursing. As a mother herself, Michelle personally identifies with the worry parents go through regarding their children’s health, which has developed her deep heart for treating our youngest population. 
JOANNE WEBSTER MSN, RN, FNP - C After serving more than twenty years in the NICU as a registered nurse, JoAnne became a nurse practitioner and became certified through the AANP. She received her bachelor's and master's degrees from Harding University and the University of Texas at Arlington, respectively, and she is a native of north Texas. In fact, the majority of her career has been in the DFW area with only a couple of years spent in the state of Virginia. Outside our clinic JoAnne enjoys reading and working in her vegetable garden. She is a mother to three sons, so she wants her patients to know that she "will treat each patient like I want my own children treated." 
MANDY LUNA MSN, FNP - BC Throughout her career of more than twenty years, Mandy has gained experience in many areas of healthcare: the ER, ICU, the cardiac catheterization lab, as well as hyperbaric medicine. She grew up in the small town of Tahoka (south of Lubbock) and earned a Bachelor of Science in Nursing from Angelo State University. She would gain a Master of Science in Nursing degree from the University of Texas at Tyler and maintain her certification from the ANCC as a family nurse practitioner. Mandy says she believes in being an advocate for children and in providing the best quality of care possible. She has lived in Cleburne with her large family since 2007 and is licensed by the Texas Board of Nursing. 
JESSICA VAUGHAN, APRN, FNP-BC
Throughout Jessica's career as a Registered Nurse, she enjoyed serving others while working in Labor & Delivery, Home Health, and the Emergency Department. In 2024, she received her Nurse Practitioner license and was excited about working in pediatrics. Jessica stated, "I want to develop relationships with those I care for, watch them grow, and celebrate milestones with them." Jessica spends time with her youngest child at multiple sporting events, practices, and games in her spare time. Jessica wants everyone to know, "I consider it my greatest honor to be able to care for and serve the children in our community." 
RACHEL GREER, PA-C
Rachel grew up in Rowlett, Texas. Rachel has a B.S. in Biology from Harding University and a Master of Medical Sciences (M.M.S.) in Physician Assistant Studies from Midwestern University in Downers Grove, IL, which she obtained in 2022. Rachel previously worked in a family medicine practice but decided to pursue her interest in pediatrics. Rachel stated, “I’m excited to move to Cleburne and be established as part of the great team at First Step Pediatrics!” In Rachel’s spare time, she enjoys reading, traveling, playing the harp, and spending time with her cat. Office staff
SIMONE AROUSE, Director of Operations Simone graduated from Carlow University of Pittsburgh with a Bachelor of Nursing in 1998. Subsequently, she joined Magee-Womens Hospital of University of Pittsburgh as an OBGYN nurse, then transitioned to outpatient pediatrics until moving to Cleburne in 2010. Alongside her husband, Dr. Arouse, the two established First Step Pediatric Associates that same year, in which she first served in the role of Office Manager. In 2015 she transitioned to the role of Director of Operations.
Dr. Arouse is credentialed with Texas Health Harris Methodist Hospital of Cleburne.
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