Individual
MISS KENNEDY RENEE GOATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
11123 US HIGHWAY 96 N, BROOKELAND, TX 75931-5402
(409) 594-3146
Mailing address
11123 US HIGHWAY 96 N, BROOKELAND, TX 75931-5402
(409) 594-3146
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
1065714
TX
Other
Enumeration date
05/09/2022
Last updated
05/09/2022
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