Provider Demographics
NPI:1013892512
Name:FELTON, LILO (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:LILO
Middle Name:
Last Name:FELTON
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:MISS
Other - First Name:LILO
Other - Middle Name:E
Other - Last Name:FELTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHNP-BC
Mailing Address - Street 1:2620 GUS THOMASSON RD STE 102
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-5417
Mailing Address - Country:US
Mailing Address - Phone:469-730-0044
Mailing Address - Fax:
Practice Address - Street 1:2620 GUS THOMASSON RD STE 102
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-5417
Practice Address - Country:US
Practice Address - Phone:469-730-0044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1200840363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health