Healthcare Provider Details

I. General information

NPI: 1154531044
Provider Name (Legal Business Name): ALISSA NICOLE BARNES NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 02/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

699 BURROUGHS ST
MORGANTOWN WV
26505-3346
US

IV. Provider business mailing address

699 BURROUGHS ST
MORGANTOWN WV
26505-3346
US

V. Phone/Fax

Practice location:
  • Phone: 304-241-6875
  • Fax:
Mailing address:
  • Phone: 304-241-6875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number2006-2146
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number79031
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: