Provider Demographics
NPI:1861067571
Name:LACOUR, QUINCHELL (CNA)
Entity type:Individual
Prefix:
First Name:QUINCHELL
Middle Name:
Last Name:LACOUR
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5499 BRAESVALLEY DR APT 495
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-3120
Mailing Address - Country:US
Mailing Address - Phone:832-955-5358
Mailing Address - Fax:
Practice Address - Street 1:5499 BRAESVALLEY DR APT 495
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-3120
Practice Address - Country:US
Practice Address - Phone:832-955-5358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNA08317986376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide