Provider Demographics
NPI:1497327084
Name:BYWATER, ASHLEY NICKOLE (LVN)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:NICKOLE
Last Name:BYWATER
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:NICKOLE
Other - Last Name:GILES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:7428 W MILITARY DR STE D
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78227-3010
Mailing Address - Country:US
Mailing Address - Phone:210-673-8111
Mailing Address - Fax:
Practice Address - Street 1:7428 W MILITARY DR STE D
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78227-3010
Practice Address - Country:US
Practice Address - Phone:210-673-8111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX336324164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse