Provider Demographics
NPI:1790221919
Name:VANBUREN, LACHERIA (FNP)
Entity Type:Individual
Prefix:
First Name:LACHERIA
Middle Name:
Last Name:VANBUREN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 N LANE WELLS DR
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75604-4009
Mailing Address - Country:US
Mailing Address - Phone:903-215-0432
Mailing Address - Fax:
Practice Address - Street 1:4910 TELEPHONE RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77087-3504
Practice Address - Country:US
Practice Address - Phone:713-641-3900
Practice Address - Fax:713-641-3901
Is Sole Proprietor?:No
Enumeration Date:2017-01-11
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131791363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner