Provider Demographics
NPI:1730695743
Name:BROWN, CHELA LACINDA (LVN)
Entity type:Individual
Prefix:
First Name:CHELA
Middle Name:LACINDA
Last Name:BROWN
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 MEADOW GATE
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-1557
Mailing Address - Country:US
Mailing Address - Phone:210-992-7136
Mailing Address - Fax:
Practice Address - Street 1:702 MEADOW GATE
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-1557
Practice Address - Country:US
Practice Address - Phone:210-992-7136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-28
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X
TX209783164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No253Z00000XAgenciesIn Home Supportive Care