Provider Demographics
NPI:1346901691
Name:BARNES, MILISA RAINE (DC)
Entity Type:Individual
Prefix:
First Name:MILISA
Middle Name:RAINE
Last Name:BARNES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:MILISA
Other - Middle Name:RAINE
Other - Last Name:FOLLMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 43
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:NE
Mailing Address - Zip Code:69154-0043
Mailing Address - Country:US
Mailing Address - Phone:308-991-9257
Mailing Address - Fax:
Practice Address - Street 1:390 MAIN ST
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:NE
Practice Address - Zip Code:69154-6112
Practice Address - Country:US
Practice Address - Phone:308-244-1872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-07
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2119111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE2119OtherLICENSE NUMBER