Provider Demographics
NPI:1124573035
Name:NARD, LAQUISHA MONIQUE
Entity Type:Individual
Prefix:
First Name:LAQUISHA
Middle Name:MONIQUE
Last Name:NARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:832 W GREENS RD APT 112
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77067-4436
Mailing Address - Country:US
Mailing Address - Phone:832-715-0093
Mailing Address - Fax:
Practice Address - Street 1:832 W GREENS RD APT 112
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77067-4436
Practice Address - Country:US
Practice Address - Phone:832-715-0093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-20
Last Update Date:2016-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3747000000374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician