Individual
ANGELA MAE LIVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
253 SHORT STREET, FORESTBURG, TX 76239
(940) 284-0893
Mailing address
253 SHORT STREET, FORESTBURG, TX 76239
(940) 284-0893
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
163630
TX
Other
Enumeration date
02/03/2020
Last updated
02/03/2020
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