Individual
JESSICA KEELY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
3356 COUNTY ROAD 313, DUBLIN, TX 76446-6631
(254) 434-9255
Mailing address
3356 COUNTY ROAD 313, DUBLIN, TX 76446-6631
(254) 434-9255
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
350190
TX
Other
Enumeration date
09/13/2019
Last updated
09/13/2019
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