Provider Demographics
NPI:1689464042
Name:BARNETT, JALASIA KAVONNA (BSN, RN)
Entity type:Individual
Prefix:
First Name:JALASIA
Middle Name:KAVONNA
Last Name:BARNETT
Suffix:
Gender:
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1024 CANE BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:WALTERBORO
Mailing Address - State:SC
Mailing Address - Zip Code:29488-0802
Mailing Address - Country:US
Mailing Address - Phone:843-510-4809
Mailing Address - Fax:
Practice Address - Street 1:1024 CANE BRANCH RD
Practice Address - Street 2:
Practice Address - City:WALTERBORO
Practice Address - State:SC
Practice Address - Zip Code:29488-0802
Practice Address - Country:US
Practice Address - Phone:843-510-4809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC270139163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine