person
Ms. Tia Roche Ivory, FNP-C
Family Nurse Practitioner in Kilgore, Texas
NPI 1689176885

Tia Roche Ivory is a Family Nurse Practitioner based in Kilgore, TX and is specialized in Family. Tia Roche Ivory practices in Kilgore, TX and has the professional credentials of FNP-C. The NPI Number for Tia Roche Ivory is 1689176885 and holds a License No. AP136828 (Texas).

The current practice location address for Tia Roche Ivory is 2019A S Henderson Blvd Ste 2, Kilgore, TX and can be reached out via phone at 903-483-7707 and via fax at 903-483-7708.

Location: 2019A S Henderson Blvd Ste 2, Kilgore, TX, 75662-3915
person
Provider Profile Details
NPI Number
1689176885
Provider Name
Tia Roche Ivory
Credential
FNP-C
Provider Entity Type
Individual
Gender
Female
Address
2019A S Henderson Blvd Ste 2, Kilgore, TX, 75662-3915
Phone Number
903-483-7707
Fax Number
903-483-7708
Provider Enumeration Date
03/03/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
8025511 01 TX AETNA
institution
Provider Business Practice Location Address Details
Address
2019A S Henderson Blvd Ste 2
City
State
Zip
75662-3567
Phone Number
903-483-7707
Fax Number
903-483-7708
person
Provider Business Mailing Address Details
Address
2019A S Henderson Blvd Ste 2
City
State
Zip
75662-3567
Phone Number
903-483-7707
Fax Number
903-483-7708
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
AP136828 (Texas)
Definition
Definition to come...
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