Individual
MRS. KYRA LEALYN BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
275 MOCKINGBIRD LN, SAN ANGELO, TX 76901-4809
(806) 891-1947
Mailing address
275 MOCKINGBIRD LN, SAN ANGELO, TX 76901-4809
(806) 891-1947
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
309890
TX
Other
Enumeration date
02/15/2018
Last updated
02/15/2018
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