Provider Demographics
NPI:1528547551
Name:LOMELI, DIANA (LVN)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:LOMELI
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:
Other - Last Name:MARQUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:1205 EXCEL DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-5837
Mailing Address - Country:US
Mailing Address - Phone:310-617-4265
Mailing Address - Fax:
Practice Address - Street 1:990 MARLANDWOOD RD
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-3365
Practice Address - Country:US
Practice Address - Phone:254-771-0852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX317434164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse