Ceddric Duirden Ayers

Individual provider Active NPI Licensed Vocational Nurse · Jefferson, TX

NPI 1720567928 · NPPES record last updated Aug 8, 2018

Key facts

NPI
1720567928
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Vocational Nurse 164X00000X
License
196038 (TX)
Practice address
120 N Walnut St
Jefferson, TX 75657-1934
Phone
(903) 665-6131
NPI assigned
Aug 8, 2018
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
196038TXMDLicensed Vocational Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
First in Pediatrics Home Health Care, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 196038 TX Yes

Addresses

Primary practice location

120 N Walnut St
Jefferson, TX 75657-1934

Mailing address

PO Box 901
Jefferson, TX 75657-0901
Phone (903) 665-6131

Other providers in Jefferson, TX

All providers in Jefferson, TX · Licensed Vocational Nurse in Texas

Sources for this page

Verify at the official NPI Registry.