Healthcare Provider Details

I. General information

NPI: 1275672461
Provider Name (Legal Business Name): DIANE BARNES N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 10/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11005 RALSTON RD SUITE 100 - G
ARVADA CO
80004-4551
US

IV. Provider business mailing address

1055 CLERMONT ST
DENVER CO
80220-3808
US

V. Phone/Fax

Practice location:
  • Phone: 303-431-0844
  • Fax: 303-456-6124
Mailing address:
  • Phone: 303-399-8020
  • Fax: 303-370-7527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number88784
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: