Individual
MISS ANNA TENNEH WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 SOTOGRANDE BLVD APT 104B, HURST, TX 76053-2612
(817) 333-9712
Mailing address
1500 SOTOGRANDE BLVD APT 104B, HURST, TX 76053-2612
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
233959
TX
Other
Enumeration date
05/14/2018
Last updated
05/14/2018
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