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NPI Code Detail

MEDICARE: ERICA NICOLE LEMMONS LVN

MEDICARE: ERICA NICOLE LEMMONS LVN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164X00000XLicensed Vocational Nurse325439TX

General Provider Information

NPI Number : 1780214494
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICA NICOLE LEMMONS LVN
Provider Business Mailing Address
First Line : 1609 CANFIELD DR APT 912
Second Line :
City : FORT WORTH
State : TX
Zip : 76120-4918
Country : US
Telephone Number : 682-230-6966
Fax Number :
Provider Business Practice Location Address
First Line : 1609 CANFIELD DR APT 912
Second Line :
City : FORT WORTH
State : TX
Zip : 76120-4918
Country : US
Telephone Number : 682-230-6966
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2020
Last Update Date : 01/22/2020

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