Individual
JAYCI WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
57 ELMA DR, ORANGE, TX 77630-1925
(409) 670-8925
Mailing address
57 ELMA DR, ORANGE, TX 77630-1925
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
361898
TX
Other
Enumeration date
04/12/2018
Last updated
04/12/2018
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