Individual
MRS. DESOLA MARY EFUNSHILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE
Contact information
Practice address
5900 BLACKBURN DR, JOSHUA, TX 76058-5427
(240) 462-3274
Mailing address
8720 NOONTIDE DR, FORT WORTH, TX 76179-5287
(240) 462-3274
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
329260
TX
Other
Enumeration date
02/18/2018
Last updated
02/18/2018
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