Provider Demographics
NPI:1598820284
Name:BARNES, LORI JANE (DNP, GNPC)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:JANE
Last Name:BARNES
Suffix:
Gender:F
Credentials:DNP, GNPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE BOX 704
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-274-1671
Mailing Address - Fax:
Practice Address - Street 1:211 WHITE SPRUCE BLVD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-1618
Practice Address - Country:US
Practice Address - Phone:585-475-8728
Practice Address - Fax:585-475-9411
Is Sole Proprietor?:No
Enumeration Date:2006-12-25
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF3406351363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03621074Medicaid