Healthcare Provider Details

I. General information

NPI: 1114849106
Provider Name (Legal Business Name): JANESSA MYCHEL BARNES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 900
CHADRON NE
69337-0900
US

IV. Provider business mailing address

PO BOX 900
CHADRON NE
69337-0900
US

V. Phone/Fax

Practice location:
  • Phone: 308-432-4050
  • Fax: 308-432-3992
Mailing address:
  • Phone: 308-432-4050
  • Fax: 308-432-3992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: