Individual
JERKINDRA LIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24929 KATY RANCH RD APT 13202, KATY, TX 77494-3806
(619) 732-2337
Mailing address
24929 KATY RANCH RD APT 13202, KATY, TX 77494-3806
(619) 732-2337
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
331397
TX
164X00000X
Licensed Vocational Nurse
Primary
333495
TX
Other
Enumeration date
08/02/2018
Last updated
06/02/2019
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