Provider Demographics
NPI:1033698568
Name:BARRERA, ANJELITA (LVN)
Entity Type:Individual
Prefix:
First Name:ANJELITA
Middle Name:
Last Name:BARRERA
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:ANGIE
Other - Middle Name:TEAKELL
Other - Last Name:BARRERA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LVN
Mailing Address - Street 1:2723 WHEATFIELD WAY
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-4799
Mailing Address - Country:US
Mailing Address - Phone:361-212-4053
Mailing Address - Fax:
Practice Address - Street 1:2723 WHEATFIELD WAY
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-4799
Practice Address - Country:US
Practice Address - Phone:361-212-4053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX213079164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse