Provider Demographics
NPI:1891355228
Name:HOUSH, SKYLYNN NOELLE
Entity Type:Individual
Prefix:
First Name:SKYLYNN
Middle Name:NOELLE
Last Name:HOUSH
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 1:16218 CAROLE DR
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE
Mailing Address - State:TX
Mailing Address - Zip Code:75791-8216
Mailing Address - Country:US
Mailing Address - Phone:903-574-0724
Mailing Address - Fax:
Practice Address - Street 1:16218 CAROLE DR
Practice Address - Street 2:
Practice Address - City:WHITEHOUSE
Practice Address - State:TX
Practice Address - Zip Code:75791-8216
Practice Address - Country:US
Practice Address - Phone:903-574-0724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX347030164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE