Individual
EMILY GRACE CARREON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IBCLC, LVN
Contact information
Practice address
1721 W HALL ST, SHOW LOW, AZ 85901-5787
(575) 313-7859
Mailing address
1721 W HALL ST, SHOW LOW, AZ 85901-5787
(575) 313-7859
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
1014455
TX
Other
Enumeration date
11/19/2020
Last updated
11/19/2020
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