Individual
KATHERINE CARNICLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
130 PECAN, VAN VLECK, TX 77482-6341
(979) 244-4899
Mailing address
130 PECAN, VAN VLECK, TX 77482-6341
(979) 244-4899
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
545667
TX
Other
Enumeration date
09/21/2018
Last updated
09/21/2018
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