Individual
JACQUELYN HATLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
6324 OAKCREST LN, AMARILLO, TX 79109-6967
(806) 223-8386
Mailing address
6324 OAKCREST LN, AMARILLO, TX 79109-6967
(806) 223-8386
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
1025802
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1025802
TEXAS BON
TX
Enumeration date
05/19/2022
Last updated
05/19/2022
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