Individual
BIANCA ROBERTA HERNDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
BLDG 5979 DESERT STORM AVE, LAPOINTE HEALTH CLINIC, FORT CAMPBELL, KY 42223-5349
(270) 956-0302
Mailing address
BLDG 5979 DESERT STORM AVE, LAPOINTE HEALTH CLINIC, FORT CAMPBELL, KY 42223-5349
(270) 956-0301
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
66744
TN
Other
Enumeration date
05/05/2006
Last updated
01/08/2009
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