Most Relevant Information
Provider Data
| NPI Number: | 1003316068 |
| Provider Name: | LAVERN HUMPHRIES |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 836362 |
Most Important Dates
| Enumeration Date: | 02/16/2018 |
| Last Updated: | 02/16/2018 |
Provider Practice Location
2016 HARVEST DR
NOLANVILLE
TX
765594732
Practice Location Phone/Fax
| Phone: | 2549317140 |
| Fax: | 2549317140 |
Provider Mailing Location
2016 HARVEST DR
NOLANVILLE
TX
765594732
Provider Mailing Phone/Fax
| Phone: | 2549317140 |
| Fax: | 2549317140 |