Individual
LISA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
213 PRYOR ST, RUSK, TX 75785-9206
(903) 721-9878
Mailing address
213 PRYOR ST, RUSK, TX 75785-9206
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
149688
TX
Other
Enumeration date
08/08/2018
Last updated
08/08/2018
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