Individual
KERON ANDRE MCNICHOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
14213 GIL REYES DR, EL PASO, TX 79938-2710
(915) 704-2683
Mailing address
3413 HICKMAN ST APT A, EL PASO, TX 79936-1843
(915) 704-2683
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
955774
TX
Other
Enumeration date
07/02/2020
Last updated
07/02/2020
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