Individual
MS. JACKIE DENISE RICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
4504 TREE LN, FORT WORTH, TX 76114-3822
(817) 805-4535
Mailing address
4504 TREE LN, FORT WORTH, TX 76114-3822
(817) 805-4535
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
330013
TX
Other
Enumeration date
05/24/2018
Last updated
05/24/2018
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