Individual
KELLY ZANDBERGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
ANGELS OF CARE, FORT WORTH, TX 76006-5924
(469) 123-4567
Mailing address
1314 LAKE ST, FORT WORTH, TX 76102
(817) 123-4567
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
980887
TX
Other
Enumeration date
08/21/2020
Last updated
10/06/2020
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