Individual
COREENA ELEANOR BARNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20 W BANK ST, PETERSBURG, VA 23803-3279
(804) 862-8002
Mailing address
20 W BANK ST, PETERSBURG, VA 23803-3279
(804) 862-8002
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0002048850
VA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0181602696
—
VA
Enumeration date
10/10/2017
Last updated
05/10/2023
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