MEDICARE: MRS. KATHLEEN MARIE BARNES RT(R)(M)(CT)

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	247200000X	Other Technician

General Provider Information

NPI Number	:	1538147178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATHLEEN MARIE BARNES RT(R)(M)(CT)

Provider Business Mailing Address
First Line	:	403 JAPONICA DR
Second Line	:
City	:	CAMDEN
State	:	NC
Zip	:	27921-6931
Country	:	US
Telephone Number	:	252-335-6606
Fax Number	:	252-335-6255

Provider Business Practice Location Address
First Line	:	COMDT CG-1122
Second Line	:	2100 2ND ST SW, SUITE 5314
City	:	WASHINGTON
State	:	DC
Zip	:	20593-0001
Country	:	US
Telephone Number	:	202-267-0801
Fax Number	:

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

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	07/08/2007

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