Provider Demographics
NPI:1235695792
Name:ROY, BARI ELIZABETH (RN)
Entity Type:Individual
Prefix:
First Name:BARI
Middle Name:ELIZABETH
Last Name:ROY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 297
Mailing Address - Street 2:
Mailing Address - City:CEREDO
Mailing Address - State:WV
Mailing Address - Zip Code:25507-0297
Mailing Address - Country:US
Mailing Address - Phone:304-544-6251
Mailing Address - Fax:
Practice Address - Street 1:1220 GREENUP AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7525
Practice Address - Country:US
Practice Address - Phone:304-544-6251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV72792163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse