Individual
AMY QUALLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RNFA
Contact information
Practice address
213 MARAL LN, AZLE, TX 76020-1164
(817) 879-3269
Mailing address
PO BOX 992, AZLE, TX 76098-0992
(817) 879-3269
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
849975
TX
Other
Enumeration date
07/22/2021
Last updated
07/22/2021
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