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Individual

MRS. LYDIA VINCENT HATHORN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, RN, WHNP-BC

Contact information

Practice address
5201 HARRY HINES BLVD, DALLAS, TX 75235-7708
(214) 590-5306
Mailing address
5646 MILLER AVE, DALLAS, TX 75206-6429
(314) 606-8521

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
420963
NY
363LW0102X
Women's Health Nurse Practitioner
Primary
AP131236
TX

Other

Enumeration date
11/14/2009
Last updated
08/16/2021
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