Individual
KRISTIN GOTTENBOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5262 SGT LYTLE AVE, EL PASO, TX 79906-3242
(915) 595-6137
Mailing address
5262 SGT LYTLE AVE, EL PASO, TX 79906-3242
(915) 595-6137
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
317065
TX
Other
Enumeration date
11/28/2016
Last updated
11/28/2016
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