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NPI Code Detail

MEDICARE: MR. JERRY DON LLOYD FNP-C

MEDICARE: MR. JERRY DON LLOYD FNP-C
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
1363LF0000XFamily Nurse Practitioner1009551TX

General Provider Information

NPI Number : 1225103773
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JERRY DON LLOYD FNP-C
Provider Business Mailing Address
First Line : 2006 E MAIN ST
Second Line :
City : MADISONVILLE
State : TX
Zip : 77864-2216
Country : US
Telephone Number : 936-225-4961
Fax Number : 936-225-5128
Provider Business Practice Location Address
First Line : 709 BARTON ST
Second Line :
City : HEARNE
State : TX
Zip : 77859-3009
Country : US
Telephone Number : 979-279-3451
Fax Number : 979-595-1704
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2006
Last Update Date : 09/12/2024

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Directions to “ MR. JERRY DON LLOYD FNP-C” Practice Location

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