Individual
KAITLYN WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
403 WARD ST, LUFKIN, TX 75901-4945
(936) 238-5699
Mailing address
438 PARKS CIR, LUFKIN, TX 75904-7381
(936) 238-5699
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
325796
TX
Other
Enumeration date
10/30/2020
Last updated
10/30/2020
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