Provider Demographics
NPI:1225103773
Name:LLOYD, JERRY DON (FNP-C)
Entity Type:Individual
Prefix:MR
First Name:JERRY
Middle Name:DON
Last Name:LLOYD
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77864-2216
Mailing Address - Country:US
Mailing Address - Phone:936-225-4961
Mailing Address - Fax:936-225-5128
Practice Address - Street 1:2006 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:TX
Practice Address - Zip Code:77864-2216
Practice Address - Country:US
Practice Address - Phone:936-225-4961
Practice Address - Fax:936-225-5128
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1009551363LF0000X, 363LF0000X
TX8580111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX653066OtherBCBS
TX8AW120OtherBCBS
TX653066Medicare PIN
TX8AW120OtherBCBS
TXU82578Medicare UPIN