Provider Demographics
NPI:1134292089
Name:KURUVILA, LANCY (RN)
Entity Type:Individual
Prefix:
First Name:LANCY
Middle Name:
Last Name:KURUVILA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 SHELBY CT
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-7130
Mailing Address - Country:US
Mailing Address - Phone:214-718-7050
Mailing Address - Fax:214-441-3079
Practice Address - Street 1:1408 SHELBY CT
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-7130
Practice Address - Country:US
Practice Address - Phone:214-718-7050
Practice Address - Fax:214-441-3079
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX544520163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health