Provider Demographics
NPI:1437637576
Name:MFULA, LINDY PRISCA (LVN)
Entity Type:Individual
Prefix:
First Name:LINDY
Middle Name:PRISCA
Last Name:MFULA
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 1:16219 SOUTHAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-7316
Mailing Address - Country:US
Mailing Address - Phone:832-768-7723
Mailing Address - Fax:
Practice Address - Street 1:16219 SOUTHAMPTON DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-7316
Practice Address - Country:US
Practice Address - Phone:832-768-7723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX218421364SH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome Health