Individual
JAKETHA LINTHECOME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1505 W GRANDE BLVD APT 1101, TYLER, TX 75703-5697
(903) 392-3379
Mailing address
1505 W GRANDE BLVD APT 1101, TYLER, TX 75703-5697
(903) 392-3379
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
329402
TX
Other
Enumeration date
05/02/2019
Last updated
05/02/2019
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