Healthcare Provider Details

I. General information

NPI: 1295893907
Provider Name (Legal Business Name): BECKY LOU ADAMS LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36000 DARNALL LOOP CARL R DARNALL ARMY MEDICAL CENTER
FORT HOOD TX
76544
US

IV. Provider business mailing address

36000 DARNALL LOOP CARL R DARNALL ARMY MEDICAL CENTER
FORT HOOD TX
76544
US

V. Phone/Fax

Practice location:
  • Phone: 254-288-8151
  • Fax: 254-288-8875
Mailing address:
  • Phone: 254-288-8151
  • Fax: 254-288-8875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number161690
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: