Provider Demographics
NPI:1205316171
Name:YATES, LORRIAN NATASHA
Entity type:Individual
Prefix:
First Name:LORRIAN
Middle Name:NATASHA
Last Name:YATES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15700 LEXINGTON BLVD APT 1023
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4168
Mailing Address - Country:US
Mailing Address - Phone:346-900-5716
Mailing Address - Fax:
Practice Address - Street 1:15700 LEXINGTON BLVD APT 1023
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4168
Practice Address - Country:US
Practice Address - Phone:346-900-5716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX216063164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse