Individual
ANITRA DA'SHAI MAYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1516 GURLEY LN APT 3104, WACO, TX 76706-3531
(254) 715-4506
Mailing address
1516 GURLEY LN APT 3104, WACO, TX 76706-3531
(254) 715-4506
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
1009370
TX
Other
Enumeration date
11/03/2020
Last updated
11/03/2020
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