MEDICARE: MS. LASONNE JACINTA ARCENEAUX 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
1	164X00000X	Licensed Vocational Nurse	222716	TX
2	164W00000X	Licensed Practical Nurse	20132414	LA

General Provider Information

NPI Number	:	1326271305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LASONNE JACINTA ARCENEAUX LVN

Provider Business Mailing Address
First Line	:	PO BOX 8442
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77288-8442
Country	:	US
Telephone Number	:	504-215-3766
Fax Number	:

Provider Business Practice Location Address
First Line	:	2380 S MACGREGOR WAY
Second Line	:	207
City	:	HOUSTON
State	:	TX
Zip	:	77021-1159
Country	:	US
Telephone Number	:	504-215-3766
Fax Number	:

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

Provider Enumeration Date	:	08/25/2009
Last Update Date	:	02/05/2015

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