Provider Demographics
NPI:1538986237
Name:BARAHONA, ANNETTE ROSIE (MA)
Entity type:Individual
Prefix:MRS
First Name:ANNETTE
Middle Name:ROSIE
Last Name:BARAHONA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 IDAHO AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44052-2178
Mailing Address - Country:US
Mailing Address - Phone:440-088-0303
Mailing Address - Fax:
Practice Address - Street 1:407 IDAHO AVE APT 2
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44052-2178
Practice Address - Country:US
Practice Address - Phone:440-308-8030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-24
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2920114163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory