Provider Demographics
NPI:1780214494
Name:LEMMONS, ERICA NICOLE (LVN)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:NICOLE
Last Name:LEMMONS
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 1:1609 CANFIELD DR APT 912
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76120-4918
Mailing Address - Country:US
Mailing Address - Phone:682-230-6966
Mailing Address - Fax:
Practice Address - Street 1:1609 CANFIELD DR APT 912
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76120-4918
Practice Address - Country:US
Practice Address - Phone:682-230-6966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX325439164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse