Provider Demographics
NPI:1124199245
Name:LOVORN, EMMA L (LVN)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:L
Last Name:LOVORN
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 1:33210 LIVE OAK PARK
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77354-6289
Mailing Address - Country:US
Mailing Address - Phone:832-876-4670
Mailing Address - Fax:281-356-5263
Practice Address - Street 1:33210 LIVE OAK PARK
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-6289
Practice Address - Country:US
Practice Address - Phone:832-876-4670
Practice Address - Fax:281-356-5263
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX151450164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse