Provider Demographics
NPI:1053146993
Name:BARNES, JAMES TAYLOR (RN)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:TAYLOR
Last Name:BARNES
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 WHITEWATER DR APT 2104
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83402-5088
Mailing Address - Country:US
Mailing Address - Phone:801-710-3525
Mailing Address - Fax:
Practice Address - Street 1:1415 WHITEWATER DR APT 2104
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83402-5088
Practice Address - Country:US
Practice Address - Phone:801-710-3525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-02
Last Update Date:2024-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID75975163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency