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General NPI Number Information
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NPI Number | 1386040467
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Entity Type | Organization
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Legal Business Name | BARNABAS HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 11/17/2014
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Last Update Date | 03/30/2020
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Provider Practice Location Address
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Address Line | 1303 JASMINE ST SUITE 101
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City | FERNANDINA BEACH
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State | FL
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Zip | 32034-2992
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Country | US
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Telephone | 904-261-7000
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Fax | 904-261-8899
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Provider Business Mailing Address
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Address Line | 1303 JASMINE ST SUITE 101
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City | FERNANDINA BEACH
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State | FL
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Zip | 32034-2992
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Country | US
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Telephone | 904-261-7000
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Fax | 904-261-8899
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. WANDA LANIER
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Credential |
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Telephone | 904-261-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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