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Individual

MISS ETTA LEORA HAMMIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LVN

Contact information

Practice address
2327 OAKLAND BLVD, FT. WORTH, TX 76011
(817) 984-1496
(817) 984-1497
Mailing address
1012 SKYLINE DR, APT 1412, ARLINGTON, TX 76011-1383
(817) 298-9792
(817) 617-3479

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
171393
TX

Other

Enumeration date
05/01/2015
Last updated
05/01/2015
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