Individual
AGNES ESOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
3914 CAMELIA GLEN LN, FRESNO, TX 77545-8762
(832) 646-9578
Mailing address
3914 CAMELIA GLEN LN, FRESNO, TX 77545-8762
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AP131875
TX
363LP2300X
Primary Care Nurse Practitioner
Primary
AP131875
TX
Other
Enumeration date
11/19/2016
Last updated
11/23/2016
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