Individual provider Active NPI

Geena Wyatt

  • Licensed Practical Nurse
  • Henrietta, TX
National Provider Identifier
1760094635
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
71410 Issued in TX
Practice address
411 N Barrett St
Henrietta, TX 76365-2203
Phone
(940) 730-0201
NPI assigned
Aug 20, 2020
Last updated
Aug 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

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

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

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
71410TXMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1760094635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 N BARRETT ST",
            "city": "HENRIETTA",
            "state": "TX",
            "postal_code": "763652203",
            "telephone_number": "940-730-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 N BARRETT ST",
            "city": "HENRIETTA",
            "state": "TX",
            "postal_code": "763652203",
            "telephone_number": "940-730-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "GEENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-20",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TX",
            "license": "71410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henrietta, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.