Provider Demographics
NPI:1598948648
Name:CLEVELAND, LORIELLE (APN)
Entity Type:Individual
Prefix:MRS
First Name:LORIELLE
Middle Name:
Last Name:CLEVELAND
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17183 I 45 S STE 670
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77385-3316
Mailing Address - Country:US
Mailing Address - Phone:936-321-8221
Mailing Address - Fax:936-321-8229
Practice Address - Street 1:17183 I 45 S STE 670
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77385-3316
Practice Address - Country:US
Practice Address - Phone:936-321-8221
Practice Address - Fax:936-321-8229
Is Sole Proprietor?:No
Enumeration Date:2007-12-12
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX694068363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology