Provider Demographics
NPI:1891463436
Name:BARNES, DONOVAN MATTHEW (RN)
Entity type:Individual
Prefix:MR
First Name:DONOVAN
Middle Name:MATTHEW
Last Name:BARNES
Suffix:
Gender:M
Credentials:RN
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Mailing Address - Street 1:PO BOX 840862
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0862
Mailing Address - Country:US
Mailing Address - Phone:303-377-7638
Mailing Address - Fax:303-377-7638
Practice Address - Street 1:8000 E MAPLEWOOD AVE STE 120
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-4766
Practice Address - Country:US
Practice Address - Phone:303-438-3999
Practice Address - Fax:720-439-9500
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-30
Last Update Date:2024-11-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4704343331163W00000X, 367500000X
COAPN.1000231-CRNA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse