Patrice Levon Nickerson, L.V.N.
Individual provider Active NPI Licensed Vocational Nurse · Mt Enterprise, TX
NPI 1598852808 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1598852808
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Vocational Nurse 164X00000X
- License
- 122948 (TX)
- Practice address
- 14915 County Road 3191 S
Mt Enterprise, TX 75681-4099 - Phone
- (903) 399-4596
- NPI assigned
- Oct 6, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 122948 | TX | MD | Licensed Vocational Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | 122948 | TX | Yes |
Addresses
Primary practice location
14915 County Road 3191 S
Mt Enterprise, TX 75681-4099
Mailing address
14915 County Road 3191 S
Mt Enterprise, TX 75681-4099
Phone (903) 399-4596
Other providers in Mt Enterprise, TX
- Carolyn Hight
- Mount Enterprise I, LLC
- Mt Enterprise Community Health Clinic
- Mt. Enterprise Isd
- Dontavia Neese
- Lisa Macdowell Rogers
- Cherryl Lynn Rowell
- Christopher Smith
- Maja Mason Steele
- Joseph Whitlow
All providers in Mt Enterprise, TX · Licensed Vocational Nurse in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.