Provider Demographics
NPI:1578044202
Name:PIGG, NINA (LVN)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:PIGG
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:NINA
Other - Middle Name:
Other - Last Name:MENDOZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:1901 MEDI PARK DR STE 2048
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-2109
Mailing Address - Country:US
Mailing Address - Phone:806-353-2101
Mailing Address - Fax:855-448-9767
Practice Address - Street 1:1901 MEDI PARK DR STE 2048
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2109
Practice Address - Country:US
Practice Address - Phone:806-353-2101
Practice Address - Fax:855-448-9767
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX323717164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse