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Individual

DEBBIE OATMAN-BROADNAX

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6161 TRAIL GLEN DR APT 129, DALLAS, TX 75217-5538
(214) 881-5485
Mailing address
6161 TRAIL GLEN DR APT 129, DALLAS, TX 75217-5538

Taxonomy

Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
207457
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1219
LVN
01
207457
LVN
TX
Enumeration date
04/12/2018
Last updated
04/12/2018
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