Individual
GABRIELLE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
807 S 13TH ST, COPPERAS COVE, TX 76522-2713
(254) 392-0523
Mailing address
807 S 13TH ST, COPPERAS COVE, TX 76522-2713
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
350516
TX
Other
Enumeration date
09/27/2019
Last updated
09/27/2019
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