Organization
LAVENDER AND LACE BIRTH & WOMENS HEALTH SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCIA DEE NELSON RN., CNM (OWNER)
(409) 789-8258
Entity
Organization
Contact information
Practice address
310 JACOB STREET, TIMPSON, TX 75975-5028
(936) 254-3338
(936) 254-3339
Mailing address
1204 GARNER ST, NACOGDOCHES, TX 75961-4278
(409) 789-8258
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
251633
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053670612
TYPE II NPI
TX
05
—
307575601
—
TX
Enumeration date
05/16/2012
Last updated
02/28/2013
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