Provider Demographics
NPI:1972793644
Name:BLUESTONE, NANCY SUE (LVN)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:SUE
Last Name:BLUESTONE
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:BLUESTONE
Other - Last Name:CANTU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:261 W HWY 462
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:TX
Mailing Address - Zip Code:78057
Mailing Address - Country:US
Mailing Address - Phone:830-665-5015
Mailing Address - Fax:
Practice Address - Street 1:1744 COUNTY ROAD 1670
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:TX
Practice Address - Zip Code:78057-2809
Practice Address - Country:US
Practice Address - Phone:830-665-6461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX157549164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse