Individual
LATIFAH RENEE WATKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
755 S BECKHAM AVE, TYLER, TX 75701-1903
(903) 534-4684
Mailing address
755 S BECKHAM AVE, TYLER, TX 75701-1903
(903) 534-4684
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
322352
TX
Other
Enumeration date
01/22/2020
Last updated
01/22/2020
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