Provider Demographics
NPI:1891169769
Name:BARNETTE, CAMELLA (LPN)
Entity Type:Individual
Prefix:
First Name:CAMELLA
Middle Name:
Last Name:BARNETTE
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 1:7407 BROOKE BLVD
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-5283
Mailing Address - Country:US
Mailing Address - Phone:330-942-3829
Mailing Address - Fax:
Practice Address - Street 1:7407 BROOKE BLVD
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-5283
Practice Address - Country:US
Practice Address - Phone:330-942-3829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-16
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN144076164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse