Provider Demographics
NPI:1235622085
Name:BARBER, MACCARA ALYESE (LPN)
Entity Type:Individual
Prefix:
First Name:MACCARA
Middle Name:ALYESE
Last Name:BARBER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1854 BLUEHILL DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-3308
Mailing Address - Country:US
Mailing Address - Phone:513-617-6895
Mailing Address - Fax:
Practice Address - Street 1:1854 BLUEHILL DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-3308
Practice Address - Country:US
Practice Address - Phone:513-617-6895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-07
Last Update Date:2019-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.170237.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse