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Individual

BRANDIE DAWN BLANK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LVN

Contact information

Practice address
525 COMMERCE ST APT 111, AZLE, TX 76020-2467
(682) 218-9816
Mailing address
525 COMMERCE ST APT 111, AZLE, TX 76020-2467
(682) 218-9816

Taxonomy

Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
233978
TX

Other

Enumeration date
05/07/2018
Last updated
05/07/2018
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