Provider Demographics
NPI:1992208664
Name:N MED
Entity type:Organization
Organization Name:N MED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:HOLBERT-FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:833-560-6633
Mailing Address - Street 1:115 N UNIVERSITY DR STE C
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75961-5126
Mailing Address - Country:US
Mailing Address - Phone:833-560-6633
Mailing Address - Fax:936-560-3105
Practice Address - Street 1:115 N UNIVERSITY DR STE C
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75961-5126
Practice Address - Country:US
Practice Address - Phone:833-560-6633
Practice Address - Fax:936-560-3105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-08
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251300000X, 251E00000X, 251J00000X, 253Z00000X, 261QH0100X, 261QR1300X, 347C00000X
TX581785251B00000X, 163W00000X
TXAP109196363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No251300000XAgenciesLocal Education Agency (LEA)Group - Multi-Specialty
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No347C00000XTransportation ServicesPrivate VehicleGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty