Healthcare Provider Details

I. General information

NPI: 1073641635
Provider Name (Legal Business Name): STARLA JO BARNES PSC,BA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 ANDOVER DR
GLENDALE KY
42740-8728
US

IV. Provider business mailing address

213 ANDOVER DR
GLENDALE KY
42740-8728
US

V. Phone/Fax

Practice location:
  • Phone: 270-369-9041
  • Fax: 270-369-0071
Mailing address:
  • Phone: 270-369-9041
  • Fax: 270-369-0071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: