Provider Demographics
NPI:1942043393
Name:ENRIQUEZ, RAYLEIGH (LVN)
Entity type:Individual
Prefix:
First Name:RAYLEIGH
Middle Name:
Last Name:ENRIQUEZ
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 1:3016 POST OAK DR
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76039-7849
Mailing Address - Country:US
Mailing Address - Phone:903-517-2439
Mailing Address - Fax:
Practice Address - Street 1:2100 N HWY 360 STE 1904
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-1040
Practice Address - Country:US
Practice Address - Phone:469-460-7090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1132217164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse