Individual
COURTNEY ROSE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
6717 COSTA DR, WACO, TX 76712-6677
(951) 419-1732
Mailing address
6717 COSTA DR, WACO, TX 76712-6677
(951) 419-1732
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
350160
TX
Other
Enumeration date
12/07/2020
Last updated
12/07/2020
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