Provider Demographics
NPI:1245475755
Name:BARNES, LINDA
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
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 1:4621 S SHRANK DR
Mailing Address - Street 2:STE D
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-5335
Mailing Address - Country:US
Mailing Address - Phone:816-529-7713
Mailing Address - Fax:816-214-6069
Practice Address - Street 1:4621 S SHRANK DR
Practice Address - Street 2:STE D
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-5335
Practice Address - Country:US
Practice Address - Phone:816-529-7713
Practice Address - Fax:816-214-6069
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-11
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOK213063033171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor