Provider Demographics
NPI:1255828729
Name:BARNER, KIERA D
Entity Type:Individual
Prefix:MRS
First Name:KIERA
Middle Name:D
Last Name:BARNER
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 1:2315 MALTBY AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23504-2216
Mailing Address - Country:US
Mailing Address - Phone:540-642-3548
Mailing Address - Fax:
Practice Address - Street 1:2315 MALTBY AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23504-2216
Practice Address - Country:US
Practice Address - Phone:540-642-3548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA$$$$$$$$$Medicaid