Provider Demographics
NPI:1376161018
Name:HELEN, KEAMBER (LVN)
Entity Type:Individual
Prefix:
First Name:KEAMBER
Middle Name:
Last Name:HELEN
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 1:110 E HAWKINS PKWY APT 4405
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-3816
Mailing Address - Country:US
Mailing Address - Phone:903-215-3490
Mailing Address - Fax:
Practice Address - Street 1:110 E HAWKINS PKWY APT 4405
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-3816
Practice Address - Country:US
Practice Address - Phone:903-215-3490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-09
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX350509164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse