Provider Demographics
NPI:1760982466
Name:KINCAID, DAMONICA NESHELLE (LVN)
Entity Type:Individual
Prefix:
First Name:DAMONICA
Middle Name:NESHELLE
Last Name:KINCAID
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 1:1531 S STATE HIGHWAY 121 APT 1022
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-5928
Mailing Address - Country:US
Mailing Address - Phone:618-203-3972
Mailing Address - Fax:
Practice Address - Street 1:1531 S STATE HIGHWAY 121 APT 1022
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-5928
Practice Address - Country:US
Practice Address - Phone:618-203-3972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX315297164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse