Individual
KEITRA WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
6601 WATAUGA RD, SUITE 122, WATAUGA, TX 76148-3331
(817) 514-5036
Mailing address
6601 WATAUGA RD, SUITE 122, WATAUGA, TX 76148-3331
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
202632
TX
Other
Enumeration date
06/18/2014
Last updated
06/18/2014
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