Individual
MRS. JILL DARLENE PRIDGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, M.S.
Contact information
Practice address
604 S 3RD ST, MABANK, TX 75147-2700
(903) 887-1073
Mailing address
1021 COUNTY ROAD 2105, KEMP, TX 75143-7501
(903) 432-9863
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 01037
TX
Other
Enumeration date
06/19/2007
Last updated
10/26/2010
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