MEDICARE: LATANYA L BARNES RN

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
1	163W00000X	Registered Nurse	R183346	MD
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	R183346	MD

General Provider Information

NPI Number	:	1740817147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATANYA L BARNES RN

Provider Business Mailing Address
First Line	:	7074 INGRAHM DR
Second Line	:
City	:	GLEN BURNIE
State	:	MD
Zip	:	21060-8358
Country	:	US
Telephone Number	:	443-889-1866
Fax Number	:

Provider Business Practice Location Address
First Line	:	1232 RACE ROAD
Second Line	:	STE 403
City	:	ROSEDALE
State	:	MD
Zip	:	21237-2123
Country	:	US
Telephone Number	:	443-868-7101
Fax Number	:	443-732-0054

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2020
Last Update Date	:	03/18/2026

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