Individual
KIMBERLY SCROGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
755 S BECKHAM AVE, TYLER, TX 75701-1903
(337) 378-9304
Mailing address
755 S BECKHAM AVE, TYLER, TX 75701-1903
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
346971
TX
Other
Enumeration date
10/28/2019
Last updated
10/28/2019
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