Provider Demographics
NPI:1770332322
Name:BARRERA DE MCCLAIN, CRISTAL ESMERALDA
Entity type:Individual
Prefix:
First Name:CRISTAL
Middle Name:ESMERALDA
Last Name:BARRERA DE MCCLAIN
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 1:6520 MAPLE DR
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MN
Mailing Address - Zip Code:55373-9331
Mailing Address - Country:US
Mailing Address - Phone:651-403-0146
Mailing Address - Fax:
Practice Address - Street 1:1121 JACKSON ST NE STE 100
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55413-3051
Practice Address - Country:US
Practice Address - Phone:612-353-6293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula