Provider Demographics
NPI:1144510900
Name:VELEZ, CARLA MICHELLE (LPN)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:MICHELLE
Last Name:VELEZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 FORNEY DR
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-2134
Mailing Address - Country:US
Mailing Address - Phone:717-283-6668
Mailing Address - Fax:
Practice Address - Street 1:3 FORNEY DR
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-2134
Practice Address - Country:US
Practice Address - Phone:717-283-6668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN287842164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse