Provider Demographics
NPI:1649771684
Name:HUIZAR-FIGUEROA, KEANA KADISHA (LVN)
Entity Type:Individual
Prefix:MISS
First Name:KEANA
Middle Name:KADISHA
Last Name:HUIZAR-FIGUEROA
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 1:1501 ARCHER CITY HWY APT 1504
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76302-5158
Mailing Address - Country:US
Mailing Address - Phone:940-923-9515
Mailing Address - Fax:
Practice Address - Street 1:1501 ARCHER CITY HWY APT 1504
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76302
Practice Address - Country:US
Practice Address - Phone:940-923-9515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-26
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX338927164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse