Individual
MRS. BREANNA JADE MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
1463 FM 304, DIBOLL, TX 75941-5203
(936) 404-8722
Mailing address
1463 FM 304, DIBOLL, TX 75941-5203
(936) 404-8722
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
352748
TX
Other
Enumeration date
04/28/2021
Last updated
04/28/2021
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