MEDICARE: NANCY KESHA BARNES STNA

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	376K00000X	Nurse's Aide	321384750702	OH

General Provider Information

NPI Number	:	1760764310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY KESHA BARNES STNA

Provider Business Mailing Address
First Line	:	4167 E 99TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44105-5241
Country	:	US
Telephone Number	:	216-551-6597
Fax Number	:

Provider Business Practice Location Address
First Line	:	4167 E 99TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44105-5241
Country	:	US
Telephone Number	:	216-551-6597
Fax Number	:

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

Provider Enumeration Date	:	09/09/2011
Last Update Date	:	09/09/2011

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