Individual
DAWNSHETTA NYCOLE SPARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2805 SHAYE LN, FORT WORTH, TX 76112-5931
(214) 670-2161
Mailing address
2805 SHAYE LN, FORT WORTH, TX 76112-5931
(214) 670-2161
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
NA0008463995
TX
Other
Enumeration date
08/19/2020
Last updated
08/19/2020
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