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Individual
STACY ANNETTE GREENWOOD
Active
Individual
STACY ANNETTE GREENWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
224662
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14204123
DRIVERS LICENSE
TX
Enumeration date
02/16/2018
Last updated
02/16/2018
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