Provider Demographics
NPI:1831113570
Name:BARNES, DEBORA G (WHNP-BC)
Entity Type:Individual
Prefix:
First Name:DEBORA
Middle Name:G
Last Name:BARNES
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1335 E INDEPENDENCE ST STE B
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-4213
Mailing Address - Country:US
Mailing Address - Phone:417-881-8818
Mailing Address - Fax:417-886-9836
Practice Address - Street 1:1335 E INDEPENDENCE ST STE B
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-4213
Practice Address - Country:US
Practice Address - Phone:417-881-8818
Practice Address - Fax:417-886-9836
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO090547363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO423924125Medicaid
MO423924125Medicaid
P36936Medicare UPIN