Individual
LARA MICHELLE PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
117 ESTATE CV, HUTTO, TX 78634-5171
(512) 914-3002
Mailing address
117 ESTATE CV, HUTTO, TX 78634-5171
(512) 914-3002
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
350907
TX
Other
Enumeration date
02/08/2020
Last updated
02/08/2020
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