Individual
GERTRUDE CHITI MACKALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE
Contact information
Practice address
6007 RUSSETT MEADOW CT, RICHMOND, TX 77407-2196
(936) 756-5974
Mailing address
6007 RUSSETT MEADOW CT, RICHMOND, TX 77407-2196
(443) 280-2625
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
980906
TX
164X00000X
Licensed Vocational Nurse
321255
TX
Other
Enumeration date
07/20/2018
Last updated
12/31/2019
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