Provider Demographics
NPI:1578698114
Name:SCHENCK, SUSAN HONAKER (LVN)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:HONAKER
Last Name:SCHENCK
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 1:4604 STEAMBOAT SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-7567
Mailing Address - Country:US
Mailing Address - Phone:254-458-7238
Mailing Address - Fax:
Practice Address - Street 1:613 COUNTY ROAD 3150
Practice Address - Street 2:
Practice Address - City:KEMPNER
Practice Address - State:TX
Practice Address - Zip Code:76539-8713
Practice Address - Country:US
Practice Address - Phone:254-458-1627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX174689164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse