Individual
JAKILRA SIMONE VANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4302 BEACH BALL DR, KILLEEN, TX 76549-4325
(254) 987-4061
Mailing address
4302 BEACH BALL DR, KILLEEN, TX 76549-4325
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
342975
TX
Other
Enumeration date
04/28/2020
Last updated
04/28/2020
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