Provider Demographics
NPI:1376764837
Name:COLBERT, BESSIE LYNN (LVN)
Entity Type:Individual
Prefix:
First Name:BESSIE
Middle Name:LYNN
Last Name:COLBERT
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 1:3643 E BALCH AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93702-2801
Mailing Address - Country:US
Mailing Address - Phone:559-266-3776
Mailing Address - Fax:
Practice Address - Street 1:3643 E BALCH AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93702-2801
Practice Address - Country:US
Practice Address - Phone:559-266-3776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN192354164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse