Provider Demographics
NPI:1467125617
Name:BARNICA, JEFFREY ROSS (RN)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:ROSS
Last Name:BARNICA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 GREYMERE RD
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-3008
Mailing Address - Country:US
Mailing Address - Phone:402-540-0728
Mailing Address - Fax:
Practice Address - Street 1:17 GREYMERE RD
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-3008
Practice Address - Country:US
Practice Address - Phone:402-540-0728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-25
Last Update Date:2021-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2348727163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse