Individual
CYNTHIA LEE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1646 BEST BLVD, WICHITA FALLS, TX 76301-8144
(940) 782-5117
Mailing address
1646 BEST BLVD, WICHITA FALLS, TX 76301-8144
(940) 782-5117
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
132703
TX
Other
Enumeration date
01/17/2019
Last updated
01/17/2019
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