Provider Demographics
NPI:1326704016
Name:BARNES, ASHLYN ENISE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:ASHLYN
Middle Name:ENISE
Last Name:BARNES
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64502 BRAE BURN AVE
Mailing Address - Street 2:
Mailing Address - City:DESERT HOT SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92240-1246
Mailing Address - Country:US
Mailing Address - Phone:760-799-1582
Mailing Address - Fax:
Practice Address - Street 1:58471 29 PALMS HWY STE 201
Practice Address - Street 2:
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-5818
Practice Address - Country:US
Practice Address - Phone:760-228-1114
Practice Address - Fax:760-228-2066
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-16
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2020043945363LF0000X
CA802315363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty