Lisa C Barnes, ARNP

Individual provider Active NPI Nurse Practitioner · Pomeroy, WA

NPI 1720274459 · NPPES record last updated Mar 11, 2010

Key facts

NPI
1720274459
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
AP30007819 (WA)
Practice address
446 Pataha St.
Pomeroy Medical Clinic
Pomeroy, WA 99347
Phone
(509) 843-1491
Fax
(509) 843-1740
NPI assigned
Sep 17, 2007
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP30007819 WA Yes

Addresses

Primary practice location

446 Pataha St.
Pomeroy Medical Clinic
Pomeroy, WA 99347

Mailing address

Garfield County Public Hospital District #1
66 N. Sixth St.
Pomeroy, WA 99347-9705
Phone (509) 843-1591

Other identifiers

IdentifierTypeStateIssuer
807849100OtherIDSTATE OF IDAHO MEDICAID
8945416OtherWAL&I

Other providers in Pomeroy, WA

All providers in Pomeroy, WA · Nurse Practitioner in Washington

Sources for this page

Verify at the official NPI Registry.