MEDICARE: MRS. MARCIA KAY BARRETT L.P.N

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	164W00000X	Licensed Practical Nurse	27009039A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	27009039A	OTHER	IN	LPN

General Provider Information

NPI Number	:	1649415852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARCIA KAY BARRETT L.P.N

Provider Business Mailing Address
First Line	:	PO BOX 571
Second Line	:
City	:	ARCADIA
State	:	IN
Zip	:	46030-0571
Country	:	US
Telephone Number	:	131-798-4480
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 N CHURCH ST.
Second Line	:
City	:	ARCADIA
State	:	IN
Zip	:	46030-0571
Country	:	US
Telephone Number	:	131-798-4480
Fax Number	:

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

Provider Enumeration Date	:	12/03/2008
Last Update Date	:	12/03/2008

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