Provider Demographics
NPI:1114427085
Name:STILES, NAOMI LYNN (LVN)
Entity Type:Individual
Prefix:MRS
First Name:NAOMI
Middle Name:LYNN
Last Name:STILES
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 1:2046 COUNTY ROAD 3492
Mailing Address - Street 2:
Mailing Address - City:TENAHA
Mailing Address - State:TX
Mailing Address - Zip Code:75974-4104
Mailing Address - Country:US
Mailing Address - Phone:936-254-4255
Mailing Address - Fax:
Practice Address - Street 1:131 COUNTY ROAD 3102
Practice Address - Street 2:
Practice Address - City:CENTER
Practice Address - State:TX
Practice Address - Zip Code:75935-5581
Practice Address - Country:US
Practice Address - Phone:936-591-8995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-17
Last Update Date:2018-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX166860163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No163W00000XNursing Service ProvidersRegistered Nurse