Provider Demographics
NPI:1083268452
Name:BARNES, MICHAEL (MSN, APRN-CNP, PMHNP)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:BARNES
Suffix:
Gender:M
Credentials:MSN, APRN-CNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16275 RIVERBIRCH DR
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-7077
Mailing Address - Country:US
Mailing Address - Phone:937-594-1142
Mailing Address - Fax:937-860-2194
Practice Address - Street 1:401 US HIGHWAY 62 S UNIT C
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OH
Practice Address - Zip Code:45133-6754
Practice Address - Country:US
Practice Address - Phone:937-594-1142
Practice Address - Fax:937-860-2194
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-24
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0249412084P0800X
OH446610363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty