Provider Demographics
NPI:1467055269
Name:BARNETTE, JESSYCA
Entity Type:Individual
Prefix:MRS
First Name:JESSYCA
Middle Name:
Last Name:BARNETTE
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 1:32715 HILAND RD
Mailing Address - Street 2:
Mailing Address - City:POMEROY
Mailing Address - State:OH
Mailing Address - Zip Code:45769-9759
Mailing Address - Country:US
Mailing Address - Phone:740-416-4297
Mailing Address - Fax:
Practice Address - Street 1:32715 HILAND RD
Practice Address - Street 2:
Practice Address - City:POMEROY
Practice Address - State:OH
Practice Address - Zip Code:45769-9759
Practice Address - Country:US
Practice Address - Phone:740-416-4297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2880539Medicaid