MEDICARE: LORRIAN NATASHA YATES

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
1	164X00000X	Licensed Vocational Nurse	216063	TX

General Provider Information

NPI Number	:	1205316171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORRIAN NATASHA YATES

Provider Business Mailing Address
First Line	:	15700 LEXINGTON BLVD APT 1023
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-4168
Country	:	US
Telephone Number	:	346-900-5716
Fax Number	:

Provider Business Practice Location Address
First Line	:	15700 LEXINGTON BLVD APT 1023
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-4168
Country	:	US
Telephone Number	:	346-900-5716
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2018
Last Update Date	:	08/20/2018

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