Bianca Roberta Herndon LPN

NPI 1003864422 - Licensed Practical Nurse - 164W00000X

NPI Details
NPI 1003864422
Gender Female
Enumeration Date 05/05/2006
Last Updated 01/08/2009
Entity Type Individual
Active Over 10 years ago
Practice Location
BLDG 5979 DESERT STORM AVE
LAPOINTE HEALTH CLINIC
FORT CAMPBELL KY, 42223-5349, US
Phone (270) 956-0302
Fax
Business Location
BLDG 5979 DESERT STORM AVE
LAPOINTE HEALTH CLINIC
FORT CAMPBELL KY, 42223-5349, US
Phone (270) 956-0301
Fax
Toxanomy
Taxonomy Code 164W00000X
License State Tennessee
License Number 66744
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According to our database, Bianca Roberta Herndon LPN NPI is 1003864422, taxonomy code is 164W00000X and license number is 66744, license state is located at Tennessee. Bianca Roberta Herndon LPN physically located at Bldg 5979 Desert Storm Ave, Fort Campbell KY, 42223-5349. NPI Number Bianca Roberta Herndon LPN has the Individual type.

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1003864422 NPI number is provided on an as is basis without warranty of any kind. 1003864422 is maintained by the National Plan & Provider Enumeration System. The contents of Bianca Roberta Herndon LPN are for informational purposes only.