Healthcare Provider Details

I. General information

NPI: 1235008889
Provider Name (Legal Business Name): JERRI BARNETT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2160 STATE RD
LANCASTER PA
17601-1812
US

IV. Provider business mailing address

2160 STATE RD
LANCASTER PA
17601-1812
US

V. Phone/Fax

Practice location:
  • Phone: 223-287-8236
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN699762
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: