Provider Demographics
NPI:1891830444
Name:JUAREZ, BLANCA LETICIA (LVN)
Entity Type:Individual
Prefix:MRS
First Name:BLANCA
Middle Name:LETICIA
Last Name:JUAREZ
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 1:15602 BASS 3 LN
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78552-2281
Mailing Address - Country:US
Mailing Address - Phone:956-364-3061
Mailing Address - Fax:
Practice Address - Street 1:4701 S SUGAR RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-7012
Practice Address - Country:US
Practice Address - Phone:956-547-5404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201997164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse