Provider Demographics
NPI:1427538768
Name:DE LEON, JANELLE EVETH (LVN)
Entity Type:Individual
Prefix:
First Name:JANELLE
Middle Name:EVETH
Last Name:DE LEON
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 1:2017 GLENDALE DR
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78541-1526
Mailing Address - Country:US
Mailing Address - Phone:956-376-8095
Mailing Address - Fax:956-972-0339
Practice Address - Street 1:5513 N MCCOLL RD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2208
Practice Address - Country:US
Practice Address - Phone:956-972-1920
Practice Address - Fax:956-972-0339
Is Sole Proprietor?:No
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX228978164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse