Individual
ELICIA HANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
12125 TAMBOURINE DR, STAFFORD, TX 77477-1242
(832) 893-2615
Mailing address
12125 TAMBOURINE DR, STAFFORD, TX 77477-1242
(832) 893-2615
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
190435
TX
Other
Enumeration date
03/29/2010
Last updated
03/29/2010
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