Individual
IVIE MASSIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
7101 WALJIM ST APT 101, TYLER, TX 75703-4904
(936) 225-9954
Mailing address
7101 WALJIM ST APT 101, TYLER, TX 75703-4904
(936) 225-9954
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
1013217
TX
Other
Enumeration date
10/15/2020
Last updated
10/15/2020
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