Individual
EVA M DICKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3012 KENESAW AVE, WICHITA FALLS, TX 76309-4241
(940) 923-3701
Mailing address
3012 KENESAW AVE, WICHITA FALLS, TX 76309-4241
(940) 923-3701
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
103274
TX
Other
Enumeration date
01/10/2019
Last updated
01/10/2019
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