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Individual

CAROL JEANETTE SHOTWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LVN

Contact information

Practice address
318 N HWY 137, WELCH, TX 79377
(806) 752-1916
Mailing address
PO BOX 457, LAMESA, TX 79331-0457
(806) 752-1916

Taxonomy

Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
307803
TX

Other

Enumeration date
01/10/2019
Last updated
01/10/2019
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