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Organization
RELYON PRACTITIONER SERVICES, PLLC
Active
Organization
RELYON PRACTITIONER SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE NICKSON-YOUNG (CEO)
(469) 231-8206
Entity
Organization
Contact information
Practice address
512 N HAMPTON RD, 303, DESOTO, TX 75115-4920
(469) 231-8206
(972) 255-3958
Mailing address
512 N HAMPTON RD, 303, DESOTO, TX 75115-4920
(469) 231-8206
(972) 255-3958
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
—
NULL
363LG0600X
Gerontology Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/06/2016
Last updated
04/11/2016
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