Provider Demographics
NPI:1134693658
Name:BARNETT, RYAN MCKAYLA (LVN)
Entity Type:Individual
Prefix:MISS
First Name:RYAN
Middle Name:MCKAYLA
Last Name:BARNETT
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:MISS
Other - First Name:RYAN
Other - Middle Name:MCKAYLA
Other - Last Name:BARNETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LVN
Mailing Address - Street 1:5 SCHMIDT LN
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-7107
Mailing Address - Country:US
Mailing Address - Phone:210-849-2572
Mailing Address - Fax:
Practice Address - Street 1:175 XOUT RANCH RD
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:TX
Practice Address - Zip Code:78058-5108
Practice Address - Country:US
Practice Address - Phone:830-377-4841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-17
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX346902164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse