Provider Demographics
NPI:1558308627
Name:BARNES, JULIE A (NP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:BARNES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:NY
Mailing Address - Zip Code:13790-2580
Mailing Address - Country:US
Mailing Address - Phone:607-729-8156
Mailing Address - Fax:607-729-2209
Practice Address - Street 1:5 COLLEGE AVE
Practice Address - Street 2:WINDSOR FAMILY CARE CENTER
Practice Address - City:WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:13754
Practice Address - Country:US
Practice Address - Phone:607-655-1230
Practice Address - Fax:607-655-3038
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY331833363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02326121Medicaid
NY02326121Medicaid
NYCC2239Medicare PIN