Provider Demographics
NPI:1962684720
Name:TREVINO, JUDY LYNN (RN)
Entity Type:Individual
Prefix:MS
First Name:JUDY
Middle Name:LYNN
Last Name:TREVINO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 285
Mailing Address - Street 2:815 VERDI RD.
Mailing Address - City:LEMING
Mailing Address - State:TX
Mailing Address - Zip Code:78050-0285
Mailing Address - Country:US
Mailing Address - Phone:830-281-5951
Mailing Address - Fax:
Practice Address - Street 1:109 N SMITH ST
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:TX
Practice Address - Zip Code:78064-4109
Practice Address - Country:US
Practice Address - Phone:830-281-8367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX555907163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse