Provider Demographics
NPI:1801410907
Name:DEAN, RAYSHELL LYNNETTE (CNA)
Entity Type:Individual
Prefix:MISS
First Name:RAYSHELL
Middle Name:LYNNETTE
Last Name:DEAN
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2275 HWY 150
Mailing Address - Street 2:
Mailing Address - City:COLDSPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77331
Mailing Address - Country:US
Mailing Address - Phone:936-340-7544
Mailing Address - Fax:
Practice Address - Street 1:2275 HWY 150
Practice Address - Street 2:
Practice Address - City:COLDSPRING
Practice Address - State:TX
Practice Address - Zip Code:77331
Practice Address - Country:US
Practice Address - Phone:936-340-7544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-04
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00600193963747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant