1396991204 NPI number — MS. KENISHA EMICA HOYLE-SMITH LVN

Table of content: MS. KENISHA EMICA HOYLE-SMITH LVN (NPI 1396991204)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396991204 NPI number — MS. KENISHA EMICA HOYLE-SMITH LVN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOYLE-SMITH
Provider First Name:
KENISHA
Provider Middle Name:
EMICA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LVN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SMITH
Provider Other First Name:
KENISHA
Provider Other Middle Name:
EMICA
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LVN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1396991204
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/26/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
135 LINDA ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HEMPHILL
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75948-9836
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
409-787-1830
Provider Business Mailing Address Fax Number:
409-787-2465

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
135 LINDA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HEMPHILL
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75948-9836
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
409-787-2465
Provider Business Practice Location Address Fax Number:
409-787-2465
Provider Enumeration Date:
08/12/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 164X00000X , with the licence number:  189989 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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