Individual
KRYSTAL GAYLE LILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
100 E FERGUSON ST STE 60A, TYLER, TX 75702
(903) 705-0070
Mailing address
1504 GINN WAY, LUFKIN, TX 75901-6038
(936) 229-5398
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
341856
TX
Other
Enumeration date
08/28/2018
Last updated
08/28/2018
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