Individual
MRS. BERNADETTE ANN VANNESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IDMT
Contact information
Practice address
1618 TRUEMPER ST, LACKLAND A F B, TX 78236-5511
(210) 671-2651
Mailing address
1618 TRUEMPER ST, LACKLAND A F B, TX 78236-5511
(210) 671-2651
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
06/02/2009
Last updated
06/02/2009
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