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Individual

LILY ANN IMPERIAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGNP-C

Contact information

Practice address
4500 S LANCASTER RD, DALLAS, TX 75216-7167
(214) 742-8387
Mailing address
2704 HEARTHSIDE LN, MANSFIELD, TX 76063-5089
(630) 776-3789

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AG07210183
TX

Other

Enumeration date
01/05/2022
Last updated
01/05/2022
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