Provider Demographics
NPI:1346898517
Name:BARNUM, DORIS MARIE
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:MARIE
Last Name:BARNUM
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 1:4008 E HENRY AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33610-3820
Mailing Address - Country:US
Mailing Address - Phone:813-626-4528
Mailing Address - Fax:813-626-4528
Practice Address - Street 1:4008 E HENRY AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-3820
Practice Address - Country:US
Practice Address - Phone:813-626-4528
Practice Address - Fax:813-626-4528
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-29
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide