Provider Demographics
NPI:1669364550
Name:BARNEY, JOLYNN RAY
Entity type:Individual
Prefix:
First Name:JOLYNN
Middle Name:RAY
Last Name:BARNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27695 TRACY RD LOT 416
Mailing Address - Street 2:
Mailing Address - City:WALBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43465-9747
Mailing Address - Country:US
Mailing Address - Phone:419-573-2695
Mailing Address - Fax:
Practice Address - Street 1:27695 TRACY RD LOT 416
Practice Address - Street 2:
Practice Address - City:WALBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43465-9747
Practice Address - Country:US
Practice Address - Phone:419-573-2695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHUM8335093747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty