Organization
LEGACY HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YONAH KNUCKLES NURSE PRACTITIONER (ADMINISTRATOR)
(817) 201-4503
Entity
Organization
Contact information
Practice address
1918 SANTA ANNA DR, ARLINGTON, TX 76001-5611
(817) 201-4503
(682) 238-3180
Mailing address
1918 SANTA ANNA DR, ARLINGTON, TX 76001-5611
(817) 201-4503
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
AG03180006
TX
Other
Enumeration date
05/05/2018
Last updated
05/05/2018
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