Healthcare Provider Details

I. General information

NPI: 1477046894
Provider Name (Legal Business Name): MATTHEW THOMAS BARNES NURSE PRACTITIONER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2018
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9400 MCKNIGHT RD
PITTSBURGH PA
15237-6007
US

IV. Provider business mailing address

810 FRANKLIN ST
MCKEESPORT PA
15132-1429
US

V. Phone/Fax

Practice location:
  • Phone: 724-591-5236
  • Fax:
Mailing address:
  • Phone: 412-779-0969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number38709
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number38709
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP018797
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP018797
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024178696
License Number StateVA
# 6
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024178696
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: