NPI 1093361321

Vongretshun Smith-Gross

Practitioner Licensed Practical Nurse Tyler, TX

Practice location

Address: 9846 Hwy 31 E, Tyler, TX 75705-2329
Phone: (903) 525-3801
Fax: (903) 525-3858

Registered specialties

Licensed Practical Nurse Primary

Nursing Service Providers Taxonomy 164W00000X Licence 196090 (TN)

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Registry record

NPI: 1093361321
Entity type: Individual
Sex (as registered): Female
NPI issued: 13 Aug 2019
Record last updated: 13 Aug 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.