Individual
HOLLY MARIE LACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
176 VZCR 4714, BEN WHEELER, TX 75754-0422
(903) 279-6547
Mailing address
PO BOX 422, BEN WHEELER, TX 75754-0422
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
795338
TX
Other
Enumeration date
07/26/2019
Last updated
07/26/2019
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