Provider Demographics
NPI:1760097042
Name:TERRELL, SHERETTA MONIQUE (LVN)
Entity Type:Individual
Prefix:
First Name:SHERETTA
Middle Name:MONIQUE
Last Name:TERRELL
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 1:1427 JOY OAKS LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77073-2845
Mailing Address - Country:US
Mailing Address - Phone:318-294-7989
Mailing Address - Fax:
Practice Address - Street 1:1427 JOY OAKS LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77073-2845
Practice Address - Country:US
Practice Address - Phone:318-294-7989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-13
Last Update Date:2020-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX188977164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse