Individual
WANDA LANETTE KURODA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
804 N PARKWAY, JACKSON, TN 38305-3058
(731) 423-3020
Mailing address
81 CALVIN DR, JACKSON, TN 38301-9080
(731) 803-3481
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN0000070657
TN
Other
Enumeration date
10/09/2007
Last updated
10/09/2007
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