Provider Demographics
NPI:1417764424
Name:BARNES-COSEY, JACULYN RENEE (MA - RELIGIOUS STUDY)
Entity type:Individual
Prefix:
First Name:JACULYN
Middle Name:RENEE
Last Name:BARNES-COSEY
Suffix:
Gender:F
Credentials:MA - RELIGIOUS STUDY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5268 GUNSTON HALL DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-3164
Mailing Address - Country:US
Mailing Address - Phone:706-424-0490
Mailing Address - Fax:
Practice Address - Street 1:5268 GUNSTON HALL DR
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-3164
Practice Address - Country:US
Practice Address - Phone:706-424-0490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-12
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide