Provider Demographics
NPI:1417236829
Name:BARNES, FELICIA JONEE (LPN)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:JONEE
Last Name:BARNES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 MELROY AVE
Mailing Address - Street 2:APT 2
Mailing Address - City:LACKAWANNA
Mailing Address - State:NY
Mailing Address - Zip Code:14218-1627
Mailing Address - Country:US
Mailing Address - Phone:716-253-9283
Mailing Address - Fax:
Practice Address - Street 1:54 MELROY AVE
Practice Address - Street 2:APT 2
Practice Address - City:LACKAWANNA
Practice Address - State:NY
Practice Address - Zip Code:14218-1627
Practice Address - Country:US
Practice Address - Phone:716-253-9283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-16
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY301910164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse