Provider Demographics
NPI:1942248745
Name:LEVERSON, TERESA DANETTE (LVN)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:DANETTE
Last Name:LEVERSON
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:MS
Other - First Name:TERESA
Other - Middle Name:DANETTE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:36000 DARNALL LOOP
Mailing Address - Street 2:CARL R DARNALL ARMY MEDICAL CENTER
Mailing Address - City:FORT HOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76544
Mailing Address - Country:US
Mailing Address - Phone:254-288-8007
Mailing Address - Fax:254-288-8875
Practice Address - Street 1:BLDG 36000 CARL R DARNALL ARMY MEDICAL CTR
Practice Address - Street 2:GENERAL SURGERY UROLOGY
Practice Address - City:FORT HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544
Practice Address - Country:US
Practice Address - Phone:254-288-8007
Practice Address - Fax:254-288-8875
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN056978164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse