Provider Demographics
NPI:1548704315
Name:BARNES, NATISHA
Entity type:Individual
Prefix:
First Name:NATISHA
Middle Name:
Last Name:BARNES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3331 WHITESTONE
Mailing Address - Street 2:UNIT 201
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741
Mailing Address - Country:US
Mailing Address - Phone:407-683-6294
Mailing Address - Fax:
Practice Address - Street 1:3331 WHITESTONE CIR
Practice Address - Street 2:UNTI 201
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-7747
Practice Address - Country:US
Practice Address - Phone:407-683-6294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-13
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor