Individual
MS. INESIA DAMETRIC RUNNELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
404 STALLINGS ST, TERRELL, TX 75160-4342
(214) 395-9841
Mailing address
404 STALLINGS ST, TERRELL, TX 75160-4342
(214) 395-9841
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
229039
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13889723
DRIVER LICENSE
TX
Enumeration date
03/10/2021
Last updated
03/10/2021
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