Kathleen Michelle Eudy, LVN

Individual provider Active NPI Licensed Vocational Nurse · Gladewater, TX

NPI 1972192912 · NPPES record last updated Jan 14, 2021

Key facts

NPI
1972192912
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Vocational Nurse 164X00000X
License
1013946 (TX)
Practice address
9941 Union Grove Rd
Gladewater, TX 75647-3630
Phone
(903) 452-5516
NPI assigned
Jan 14, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1013946TXMDLicensed Vocational Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 1013946 TX Yes

Addresses

Primary practice location

9941 Union Grove Rd
Gladewater, TX 75647-3630

Mailing address

9941 Union Grove Rd
Gladewater, TX 75647-3630
Phone (903) 452-5516

Other providers in Gladewater, TX

All providers in Gladewater, TX · Licensed Vocational Nurse in Texas

Sources for this page

Verify at the official NPI Registry.