Healthcare Provider Details

I. General information

NPI: 1407144561
Provider Name (Legal Business Name): JENNIFER BURTON BARNARD DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2011
Last Update Date: 01/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 LUBRANO DR STE 201
ANNAPOLIS MD
21401-7564
US

IV. Provider business mailing address

129 LUBRANO DR STE 301
ANNAPOLIS MD
21401-7564
US

V. Phone/Fax

Practice location:
  • Phone: 410-224-2626
  • Fax: 410-224-0512
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number23731
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: