Individual
MISS GENEVA BARNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
350 N WALL ST, DEPT OF ANESTHESIA, KANKAKEE, IL 60901-2901
(815) 935-7515
Mailing address
1305 WALT WHITMAN RD STE 300, MELVILLE, NY 11747-4300
(865) 342-9014
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041316637
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209007598
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079196
AANA ID#
IL
01
—
P01059360
RAILROAD MEDICARE
IL
05
—
XXXXX2947001
—
IL
Enumeration date
05/20/2009
Last updated
11/14/2023
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