Provider Demographics
NPI:1134690928
Name:NELSON, LAVEDA DENISE (LVN)
Entity type:Individual
Prefix:MRS
First Name:LAVEDA
Middle Name:DENISE
Last Name:NELSON
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:MS
Other - First Name:LAVEDA
Other - Middle Name:DENISE
Other - Last Name:EARL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:14855 MEMORIAL DR APT 1011
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-5244
Mailing Address - Country:US
Mailing Address - Phone:702-353-1816
Mailing Address - Fax:
Practice Address - Street 1:14855 MEMORIAL DR APT 1011
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-5244
Practice Address - Country:US
Practice Address - Phone:702-353-1816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-06
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX342903164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse