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NPI Code Detail

MEDICARE: MS. JENNIFER MCBROOM LVN

MEDICARE:  MS. JENNIFER  MCBROOM  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 Nurse191294TX

General Provider Information

NPI Number : 1114241742
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JENNIFER MCBROOM LVN
Provider Business Mailing Address
First Line : 4141 VISTA RD
Second Line :
City : PASADENA
State : TX
Zip : 77504-2113
Country : US
Telephone Number : 713-947-3100
Fax Number : 713-947-6103
Provider Business Practice Location Address
First Line : 4141 VISTA RD
Second Line :
City : PASADENA
State : TX
Zip : 77504-2113
Country : US
Telephone Number : 713-947-3100
Fax Number : 713-947-6103
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2010
Last Update Date : 03/25/2010

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Directions to “ MS. JENNIFER MCBROOM LVN” Practice Location

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