Provider Demographics
NPI:1114490414
Name:ORELLANA, GLORIA YANETH (LVN)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:YANETH
Last Name:ORELLANA
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 1:12014 QUIET WATER CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-3933
Mailing Address - Country:US
Mailing Address - Phone:832-887-7713
Mailing Address - Fax:
Practice Address - Street 1:607 EVERETT ST
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-1828
Practice Address - Country:US
Practice Address - Phone:832-887-7713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-09
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX206053164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse