Provider Demographics
NPI:1790249878
Name:VOISIN, JACQULYN LAVERN
Entity Type:Individual
Prefix:
First Name:JACQULYN
Middle Name:LAVERN
Last Name:VOISIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 SYNOTT RD APT 1104
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-3550
Mailing Address - Country:US
Mailing Address - Phone:832-884-4269
Mailing Address - Fax:
Practice Address - Street 1:2727 SYNOTT RD APT 1104
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-3550
Practice Address - Country:US
Practice Address - Phone:832-884-4269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX137031164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse