Provider Demographics
NPI:1386064780
Name:AARON-BARBER, DESIREE AVEDON (LPN)
Entity type:Individual
Prefix:MRS
First Name:DESIREE
Middle Name:AVEDON
Last Name:AARON-BARBER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MINOT VA CBOC
Mailing Address - Street 2:MINOT AIR FORCE BASE
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58705
Mailing Address - Country:US
Mailing Address - Phone:701-727-9800
Mailing Address - Fax:701-727-9804
Practice Address - Street 1:MINOT VA CBOC
Practice Address - Street 2:MINOT AIR FORCE BASE
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58705
Practice Address - Country:US
Practice Address - Phone:701-727-9800
Practice Address - Fax:701-727-9804
Is Sole Proprietor?:No
Enumeration Date:2014-04-24
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDL14532164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse