MEDICARE: PROF. JACQUELINE BARNETT MSHS, PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	C0001643	MD

General Provider Information

NPI Number	:	1295997492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PROF. JACQUELINE BARNETT MSHS, PA-C

Provider Business Mailing Address
First Line	:	6201 GREENBELT RD STE M16
Second Line	:
City	:	BERWYN HEIGHTS
State	:	MD
Zip	:	20740-2333
Country	:	US
Telephone Number	:	301-441-4400
Fax Number	:	301-441-3008

Provider Business Practice Location Address
First Line	:	6201 GREENBELT RD STE M16
Second Line	:
City	:	BERWYN HEIGHTS
State	:	MD
Zip	:	20740-2333
Country	:	US
Telephone Number	:	301-441-4400
Fax Number	:	301-441-3008

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2008
Last Update Date	:	06/28/2008

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