Provider Demographics
NPI:1770833782
Name:BARIONNETTE, EGLA (LPN)
Entity Type:Individual
Prefix:MRS
First Name:EGLA
Middle Name:
Last Name:BARIONNETTE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6261 POLO DR W
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-9408
Mailing Address - Country:US
Mailing Address - Phone:614-595-5889
Mailing Address - Fax:
Practice Address - Street 1:6261 POLO DR W
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-9408
Practice Address - Country:US
Practice Address - Phone:614-595-5889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH148049164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse