Individual
CHARLESANNA LANGSTON MUSILI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5825 DIAZ AVE, FORT WORTH, TX 76107-5803
(214) 783-8242
Mailing address
5825 DIAZ AVE, FORT WORTH, TX 76107-5803
(214) 783-8242
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
196310
TX
Other
Enumeration date
10/09/2019
Last updated
10/09/2019
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