Provider Demographics
NPI:1619560588
Name:BARCUS, SERBELEONA NAKITA
Entity Type:Individual
Prefix:
First Name:SERBELEONA
Middle Name:NAKITA
Last Name:BARCUS
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 1:4 ROUSH HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:BIDWELL
Mailing Address - State:OH
Mailing Address - Zip Code:45614-9068
Mailing Address - Country:US
Mailing Address - Phone:740-416-5011
Mailing Address - Fax:
Practice Address - Street 1:4 ROUSH HOLLOW RD
Practice Address - Street 2:
Practice Address - City:BIDWELL
Practice Address - State:OH
Practice Address - Zip Code:45614-9068
Practice Address - Country:US
Practice Address - Phone:740-416-5011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant