Individual
MRS. AMY DIANE CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
912 E 5TH ST, ODESSA, TX 79761-4605
(432) 334-8845
(432) 334-8875
Mailing address
10555 W HACIENDA DR, ODESSA, TX 79763-7208
(432) 770-2107
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP144543
TX
Other
Enumeration date
01/10/2020
Last updated
08/24/2021
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