Provider Demographics
NPI:1487251443
Name:BARTON, ILONA (LVN)
Entity type:Individual
Prefix:
First Name:ILONA
Middle Name:
Last Name:BARTON
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:ILONA
Other - Middle Name:
Other - Last Name:KIKNADZE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:11700 WALLSTREET APT 15306
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-1882
Mailing Address - Country:US
Mailing Address - Phone:210-905-5106
Mailing Address - Fax:
Practice Address - Street 1:11700 WALLSTREET APT 15306
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-1882
Practice Address - Country:US
Practice Address - Phone:210-905-5106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA275342164X00000X
TX323953164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse