Individual
KRYSTIAN NICOLE BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
602 SE 28TH AVE, MINERAL WELLS, TX 76067-5738
(940) 468-9691
Mailing address
602 SE 28TH AVE, MINERAL WELLS, TX 76067-5738
(940) 468-9691
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
321360
TX
Other
Enumeration date
10/15/2019
Last updated
10/15/2019
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