Provider Demographics
NPI:1275877938
Name:BARNES, JENNIFER M (OTR-L)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:M
Last Name:BARNES
Suffix:
Gender:F
Credentials:OTR-L
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:M
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR-L
Mailing Address - Street 1:1820 HILLCREST DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-3636
Mailing Address - Country:US
Mailing Address - Phone:402-682-4808
Mailing Address - Fax:402-682-6563
Practice Address - Street 1:1820 HILLCREST DR
Practice Address - Street 2:SUITE A
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-3636
Practice Address - Country:US
Practice Address - Phone:402-682-4808
Practice Address - Fax:402-682-6563
Is Sole Proprietor?:No
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE466225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist