Individual
DEWANNA MICHELLE TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10105 STATE HIGHWAY 11, WHITEWRIGHT, TX 75491-5346
(903) 624-9258
Mailing address
10105 STATE HIGHWAY 11, WHITEWRIGHT, TX 75491-5346
(903) 624-9258
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
181533
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181533
—
TX
Enumeration date
02/20/2018
Last updated
02/20/2018
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