Individual
MS. LISA JEAN BARNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, PA-C
Contact information
Practice address
901 MONTGOMERY ST, DECORAH, IA 52101-2325
(563) 382-2911
Mailing address
901 MONTGOMERY ST, DECORAH, IA 52101-2325
(563) 382-2911
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
079329
IA
363A00000X
Physician Assistant
085002224
IL
363A00000X
Physician Assistant
Primary
9397
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
654425800
—
MN
01
—
970013419
MEDICARE RAILROAD
MN
Enumeration date
08/25/2006
Last updated
09/22/2015
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