Individual
EBONY N MIDCALF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4323 N JOSEY LN, STE 306, CARROLLTON, TX 75010-4633
(972) 939-7011
Mailing address
6779 SILVER OAK PL, MEMPHIS, TN 38120-4503
(228) 596-4612
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
1796
TX
363LW0102X
Women's Health Nurse Practitioner
Primary
AP120894
TX
363LW0102X
Women's Health Nurse Practitioner
R886916
MS
Other
Enumeration date
07/01/2011
Last updated
07/08/2021
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