Individual
MRS. KELLI NICHOALE WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
107 SLATON DR, BOWIE, TX 76230-4034
(940) 577-2524
Mailing address
107 SLATON DR, BOWIE, TX 76230-4034
(940) 577-2524
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
344782
TX
Other
Enumeration date
01/14/2019
Last updated
01/14/2019
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