Provider Demographics
NPI:1821592692
Name:PHELPS, FELICIA LASHUN (REGISTERED NURSE)
Entity Type:Individual
Prefix:MS
First Name:FELICIA
Middle Name:LASHUN
Last Name:PHELPS
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3885 FM 1399
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:TX
Mailing Address - Zip Code:75563-3929
Mailing Address - Country:US
Mailing Address - Phone:903-306-4255
Mailing Address - Fax:
Practice Address - Street 1:308 W NOLANA AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2528
Practice Address - Country:US
Practice Address - Phone:903-881-3178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX623002163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health