Individual
GEENA WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
411 N BARRETT ST, HENRIETTA, TX 76365-2203
(940) 730-0201
Mailing address
411 N BARRETT ST, HENRIETTA, TX 76365-2203
(940) 730-0201
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
71410
TX
Other
Enumeration date
08/20/2020
Last updated
08/20/2020
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