Healthcare Provider Details

I. General information

NPI: 1346970647
Provider Name (Legal Business Name): LISA DANIELLE BARNES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2022
Last Update Date: 06/10/2022
Certification Date: 06/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 BRIARIDGE DR APT L
TURTLE CREEK PA
15145-1174
US

IV. Provider business mailing address

108 BRIARIDGE DR APT L
TURTLE CREEK PA
15145-1174
US

V. Phone/Fax

Practice location:
  • Phone: 412-607-5836
  • Fax:
Mailing address:
  • Phone: 412-607-5836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number61283601
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier61283601
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerPA DEPARTMENT OF HEALTH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: