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General NPI Number Information
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NPI Number | 1518634922
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Entity Type | Organization
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Legal Business Name | HUDDLENURSE
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Dates
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Enumeration Date | 08/24/2021
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Last Update Date | 08/24/2021
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Provider Practice Location Address
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Address Line | 613 N ELKHART AVE APT A
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City | LUBBOCK
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State | TX
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Zip | 79416-1446
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Country | US
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Telephone | 737-808-5898
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Fax | 806-375-3200
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Provider Business Mailing Address
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Address Line | 1400 WESTINGHOUSE RD APT 5013
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City | GEORGETOWN
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State | TX
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Zip | 78626-2380
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Country | US
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Telephone | 737-808-5898
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Fax | 806-375-3200
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Authorized Official
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Title or Position | CEO
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Name | SHANDA N BROWN
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Credential |
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Telephone | 737-808-5898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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