Individual
KENNITHA BARNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1100 W 6TH AVE, GARY, IN 46402-1711
(219) 885-4264
Mailing address
1100 W 6TH AVE, GARY, IN 46402-1711
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
28207773A
IN
Other
Enumeration date
03/05/2019
Last updated
03/11/2020
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