Provider Demographics
NPI:1053682898
Name:BARBRE, ANITRA DENICE
Entity Type:Individual
Prefix:
First Name:ANITRA
Middle Name:DENICE
Last Name:BARBRE
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 1:3940 N MARTIN LUTHER KING BL
Mailing Address - Street 2:SUITE 106
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032
Mailing Address - Country:US
Mailing Address - Phone:702-476-5058
Mailing Address - Fax:702-476-5125
Practice Address - Street 1:3940 N MARTIN LUTHER KING BL
Practice Address - Street 2:SUITE 106
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032
Practice Address - Country:US
Practice Address - Phone:702-476-5058
Practice Address - Fax:702-476-5125
Is Sole Proprietor?:No
Enumeration Date:2012-01-25
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant