Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kynnadi Ayri Wallace

Individual provider Athletic Trainer · NPI 1659266641

Kynnadi Ayri Wallace is an Athletic Trainer in Stephenville, Texas. Registered with an NPI since 2025.

In the registry since
2025
Specialties on file
2

Practice location Address checks out

1333 W Washington St
Stephenville, TX 76401-4168
Phone: (254) 968-9186
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X
Athletic Trainer Taxonomy 2255A2300X

Record details

NPI number1659266641
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 10, 2025
Last updated in NPPESJune 10, 2025
Certification dateJune 10, 2025
Mailing address504 W Clover Park Dr, Fort Worth, TX 76140-6545

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