Geena Wyatt

Individual provider Active NPI Licensed Practical Nurse · Henrietta, TX

NPI 1760094635 · NPPES record last updated Aug 20, 2020

Key facts

NPI
1760094635
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
71410 (TX)
Practice address
411 N Barrett St
Henrietta, TX 76365-2203
Phone
(940) 730-0201
NPI assigned
Aug 20, 2020
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
71410TXMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 71410 TX Yes

Addresses

Primary practice location

411 N Barrett St
Henrietta, TX 76365-2203

Mailing address

411 N Barrett St
Henrietta, TX 76365-2203
Phone (940) 730-0201

Other providers in Henrietta, TX

All providers in Henrietta, TX · Licensed Practical Nurse in Texas

Sources for this page

Verify at the official NPI Registry.