Individual
KORAH CROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
3801 STATE HIGHWAY 198 APT 127, MALAKOFF, TX 75148-4988
(903) 519-4663
Mailing address
3801 STATE HIGHWAY 198 APT 127, MALAKOFF, TX 75148-4988
(903) 519-4663
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
345233
TX
Other
Enumeration date
09/25/2018
Last updated
09/25/2018
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