Provider Demographics
NPI:1770063943
Name:ECORD, KRISHA LEANNE (LVN)
Entity type:Individual
Prefix:
First Name:KRISHA
Middle Name:LEANNE
Last Name:ECORD
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 1:2620 E HIGHWAY 67
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76031-8194
Mailing Address - Country:US
Mailing Address - Phone:817-933-2666
Mailing Address - Fax:
Practice Address - Street 1:2620 E HIGHWAY 67
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76031-8194
Practice Address - Country:US
Practice Address - Phone:817-933-2666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX344398164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse