Individual
ELIZABETH ANNE MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4320 HEAVENLY LN, PROSPER, TX 75078-9690
(469) 426-5647
Mailing address
4320 HEAVENLY LN, PROSPER, TX 75078-9690
(469) 426-5647
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
755903
TX
Other
Enumeration date
12/19/2019
Last updated
12/19/2019
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