Healthcare Provider Details

I. General information

NPI: 1518905363
Provider Name (Legal Business Name): MARY MAGDALENE BARRS CNA/HHA
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

824 94TH AVE N
NAPLES FL
34108-2451
US

IV. Provider business mailing address

5780 12TH AVE SW
NAPLES FL
34116-4908
US

V. Phone/Fax

Practice location:
  • Phone: 239-597-9696
  • Fax: 239-597-9696
Mailing address:
  • Phone: 239-455-5828
  • Fax: 239-455-5828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberCNA 32188
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: