Provider Demographics
NPI:1124671334
Name:BARKSDALE, DIONNA ELIZABETH GRACE (STNA)
Entity type:Individual
Prefix:
First Name:DIONNA
Middle Name:ELIZABETH GRACE
Last Name:BARKSDALE
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 WHITE HOUSE LN
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-2542
Mailing Address - Country:US
Mailing Address - Phone:614-937-3860
Mailing Address - Fax:
Practice Address - Street 1:304 WHITE HOUSE LN
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-2542
Practice Address - Country:US
Practice Address - Phone:614-937-3860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-17
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide