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NPI Code Detail

MEDICARE: TARA C BARNES APRN

MEDICARE: TARA C BARNES APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse PractitionerAP05960LA

General Provider Information

NPI Number : 1073842134
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARA C BARNES APRN
Provider Business Mailing Address
First Line : POST OFFICE BOX 1786
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70602-1786
Country : US
Telephone Number : 337-478-9653
Fax Number : 337-474-0988
Provider Business Practice Location Address
First Line : 1614 WOLF CIR
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70605-2348
Country : US
Telephone Number : 337-478-9653
Fax Number : 337-474-0988
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2009
Last Update Date : 12/18/2009

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