Provider Demographics
NPI:1538640248
Name:RAMOS, JACQUELINE NICHOLE (LVN)
Entity Type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:NICHOLE
Last Name:RAMOS
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 1:6711 DALHART LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-2819
Mailing Address - Country:US
Mailing Address - Phone:214-802-7979
Mailing Address - Fax:
Practice Address - Street 1:6711 DALHART LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75214-2819
Practice Address - Country:US
Practice Address - Phone:214-802-7979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX161623164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse