Provider Demographics
NPI:1912003369
Name:BARNES, MARILYN ALEXANDER (FNP)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:ALEXANDER
Last Name:BARNES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 WYOMING AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-6922
Mailing Address - Country:US
Mailing Address - Phone:302-678-3652
Mailing Address - Fax:302-678-0545
Practice Address - Street 1:1095 S BRADFORD ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-4141
Practice Address - Country:US
Practice Address - Phone:302-678-2000
Practice Address - Fax:302-346-0181
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0000231363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000989242Medicaid
DE0000989242Medicaid
DEP05204Medicare UPIN