Individual
KRISTOPHER F WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
4002 22ND ST, LUBBOCK, TX 79410-1139
(806) 725-0019
Mailing address
7304 KEWANEE AVE, LUBBOCK, TX 79424-7075
(806) 535-2447
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
823088
TX
Other
Enumeration date
03/17/2020
Last updated
03/17/2020
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