Provider Demographics
NPI:1619546504
Name:HALLENBECK, ALBATINA (LPN)
Entity Type:Individual
Prefix:
First Name:ALBATINA
Middle Name:
Last Name:HALLENBECK
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 W WESTCHESTER PKWY APT 17102
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-3265
Mailing Address - Country:US
Mailing Address - Phone:469-987-0074
Mailing Address - Fax:
Practice Address - Street 1:1111 W MOCKINGBIRD LN STE 1400
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-5014
Practice Address - Country:US
Practice Address - Phone:469-619-0509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX145881164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse