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Individual

LAI-LANI MARIE HENRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
36065 SANTA FE AVE, FORT HOOD, TX 76544-5060
(808) 347-5185
Mailing address
36065 SANTA FE AVE, FORT HOOD, TX 76544-5060
(808) 347-5185

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
17211
HI
164X00000X
Licensed Vocational Nurse
Primary
1012311
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0
FAMILY PRACTICE
Enumeration date
02/26/2018
Last updated
04/30/2021
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