Provider Demographics
NPI:1295463370
Name:BARNES, MATRINA LAVONNE
Entity type:Individual
Prefix:
First Name:MATRINA
Middle Name:LAVONNE
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 1:1801 BREWTON CT
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747-1841
Mailing Address - Country:US
Mailing Address - Phone:301-257-8925
Mailing Address - Fax:
Practice Address - Street 1:3670 HAYES ST NE APT 104
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-7512
Practice Address - Country:US
Practice Address - Phone:347-860-4413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant