Provider Demographics
NPI:1013107424
Name:GEORGE, LAUREL FITZHENRY (CNA)
Entity Type:Individual
Prefix:
First Name:LAUREL
Middle Name:FITZHENRY
Last Name:GEORGE
Suffix:
Gender:F
Credentials:CNA
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 318
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77305-0318
Mailing Address - Country:US
Mailing Address - Phone:713-582-2459
Mailing Address - Fax:
Practice Address - Street 1:2 HI LO LN
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77303-1539
Practice Address - Country:US
Practice Address - Phone:713-582-2459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNA08453117376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide