Individual
OCTAVIA LATRICE KENNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1022 BLAIR FIELD LN, FRESNO, TX 77545-8689
(337) 570-8647
Mailing address
1022 BLAIR FIELD LN, FRESNO, TX 77545-8689
(337) 570-8647
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
NA726278
TX
Other
Enumeration date
09/17/2024
Last updated
09/20/2024
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