Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 675801 | TX |
NPI | 1003073800 |
---|---|
Provider Name | Mrs. Kamesha Jennel Barnes |
First Address | Jasper, TX 75951-4916 |
Second Address | Jasper, TX 75951 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2008 |
Last Update Date | 27/08/2018 |