Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 22598 | WV |
N | 207Q00000X | Family Doctor | 35120427 | OH |
NPI | 1003034281 |
---|---|
Provider Name | Katrina R Barnes |
First Address | Marietta, OH 45750-0449 |
Second Address | Williamstown, WV 26187-1249 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2007 |
Last Update Date | 10/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0072600 | (05) | OH |
3810020671 | (05) | WV |