Provider Demographics
NPI:1447751565
Name:STOGNER, AERIOLE NICHOLE (LVN)
Entity Type:Individual
Prefix:MRS
First Name:AERIOLE
Middle Name:NICHOLE
Last Name:STOGNER
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 1:1402 AVENUE J
Mailing Address - Street 2:
Mailing Address - City:CISCO
Mailing Address - State:TX
Mailing Address - Zip Code:76437-4212
Mailing Address - Country:US
Mailing Address - Phone:254-433-9023
Mailing Address - Fax:
Practice Address - Street 1:1402 AVENUE J
Practice Address - Street 2:
Practice Address - City:CISCO
Practice Address - State:TX
Practice Address - Zip Code:76437-4212
Practice Address - Country:US
Practice Address - Phone:254-433-9023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-23
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX328587164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse