Provider Demographics
NPI:1427748797
Name:BARCLAY, SHYANNA MARIE
Entity type:Individual
Prefix:
First Name:SHYANNA
Middle Name:MARIE
Last Name:BARCLAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 S NEVADA HIGHWAY 160 STE 8-129
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048-2176
Mailing Address - Country:US
Mailing Address - Phone:775-764-8999
Mailing Address - Fax:
Practice Address - Street 1:1840 E CALVADA BLVD STE 9
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-5843
Practice Address - Country:US
Practice Address - Phone:775-751-8883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-10
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV372600000X, 372500000X, 376J00000X, 3747A0650X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372600000XNursing Service Related ProvidersAdult Companion
No372500000XNursing Service Related ProvidersChore Provider
No376J00000XNursing Service Related ProvidersHomemaker
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider