Provider Demographics
NPI:1730647454
Name:BARNES, DEBORAH JEAN
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:JEAN
Last Name:BARNES
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 1:496 DRIFTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BENTON
Mailing Address - State:OH
Mailing Address - Zip Code:44449-9711
Mailing Address - Country:US
Mailing Address - Phone:330-853-5321
Mailing Address - Fax:
Practice Address - Street 1:496 DRIFTWOOD AVE
Practice Address - Street 2:
Practice Address - City:NORTH BENTON
Practice Address - State:OH
Practice Address - Zip Code:44449-9711
Practice Address - Country:US
Practice Address - Phone:330-853-5321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-12
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.054753.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse