Ivorine Barnes, MS RD

Individual provider Active NPI Registered Dietitian · Douglasville, GA

NPI 1184920522 · NPPES record last updated Feb 18, 2016

Key facts

NPI
1184920522
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
LD003027 (GA)
Practice address
2412 Wilshire Way
Douglasville, GA 30135
Phone
(678) 401-4771
Fax
(678) 401-4771
NPI assigned
Feb 2, 2011
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Science

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X LD003027 GA Yes

Addresses

Primary practice location

2412 Wilshire Way
Douglasville, GA 30135

Mailing address

2412 Wilshire Way
Douglasville, GA 30135-8129
Phone (678) 401-4771

Other providers in Douglasville, GA

All providers in Douglasville, GA · Registered Dietitian in Georgia

Sources for this page

Verify at the official NPI Registry.