Provider Demographics
NPI:1003671132
Name:WREN, KIA (LVN)
Entity Type:Individual
Prefix:
First Name:KIA
Middle Name:
Last Name:WREN
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10738 PAULWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77071-1602
Mailing Address - Country:US
Mailing Address - Phone:510-798-6813
Mailing Address - Fax:713-893-6717
Practice Address - Street 1:10738 PAULWOOD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77071-1602
Practice Address - Country:US
Practice Address - Phone:510-798-6813
Practice Address - Fax:713-893-6717
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility