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Individual

ALISA SUBULWA CHIKOSHA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1527 W STATE HIGHWAY 114, GRAPEVINE, TX 76051-8646
(817) 721-6893
Mailing address
1527 W STATE HIGHWAY 114, GRAPEVINE, TX 76051-8646

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1094934
TX

Other

Enumeration date
03/14/2023
Last updated
03/19/2023
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