Individual
JAELYNDA PROTHERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13787 MACDONA LACOSTE RD LOT 20, ATASCOSA, TX 78002-3532
(210) 502-4681
Mailing address
13787 MACDONA LACOSTE RD LOT 20, ATASCOSA, TX 78002-3532
(210) 502-4681
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
1010784
TX
Other
Enumeration date
11/04/2020
Last updated
11/04/2020
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