Individual
MRS. SUSAN EILEEN WEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
100 E FERGUSON ST STE 608, TYLER, TX 75702-5756
(903) 705-0070
(903) 405-3932
Mailing address
17872 COUNTY ROAD 322A, TERRELL, TX 75160-0206
(214) 866-9660
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
155467
TX
Other
Enumeration date
09/07/2018
Last updated
09/07/2018
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