Healthcare Provider Details

I. General information

NPI: 1174508881
Provider Name (Legal Business Name): DEBORAH J BARNES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 E 25TH ST
CHEYENNE WY
82001-3133
US

IV. Provider business mailing address

926 SKYLINE DR
CHEYENNE WY
82009-3616
US

V. Phone/Fax

Practice location:
  • Phone: 307-637-3953
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number8765
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: