Individual
BRANDY SHERELL FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
901 CREPE MYRTLE LN, LONGVIEW, TX 75604-6908
(903) 445-3664
Mailing address
901 CREPE MYRTLE LN, LONGVIEW, TX 75604-6908
(903) 445-3664
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
336320
TX
Other
Enumeration date
03/15/2018
Last updated
03/15/2018
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