Provider Demographics
NPI:1154957249
Name:MUSICK, ALICIA EYVONNE (LVN)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:EYVONNE
Last Name:MUSICK
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 1:111 LARKSPUR LN
Mailing Address - Street 2:
Mailing Address - City:PALESTINE
Mailing Address - State:TX
Mailing Address - Zip Code:75803-5425
Mailing Address - Country:US
Mailing Address - Phone:936-545-6193
Mailing Address - Fax:
Practice Address - Street 1:111 LARKSPUR LN
Practice Address - Street 2:
Practice Address - City:PALESTINE
Practice Address - State:TX
Practice Address - Zip Code:75803-5425
Practice Address - Country:US
Practice Address - Phone:936-545-6193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-20
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX336267164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse