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NPI Code Detail

MEDICARE: NICOYA LONYEE HUTCHERSON

MEDICARE: NICOYA LONYEE HUTCHERSON
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 Nurse340425TX

General Provider Information

NPI Number : 1871078857
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOYA LONYEE HUTCHERSON
Provider Business Mailing Address
First Line : 4928 LIVE OAK ST APT 214
Second Line :
City : DALLAS
State : TX
Zip : 75206-7675
Country : US
Telephone Number : 832-425-0977
Fax Number :
Provider Business Practice Location Address
First Line : 4928 LIVE OAK ST APT 214
Second Line :
City : DALLAS
State : TX
Zip : 75206-7675
Country : US
Telephone Number : 832-425-0977
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2018
Last Update Date : 09/26/2018

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Directions to “ NICOYA LONYEE HUTCHERSON ” Practice Location

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