Provider Demographics
NPI:1053193169
Name:BABAA, BARINUA
Entity type:Individual
Prefix:
First Name:BARINUA
Middle Name:
Last Name:BABAA
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 1:3302 WINDY HILL PT
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-4132
Mailing Address - Country:US
Mailing Address - Phone:678-791-2385
Mailing Address - Fax:
Practice Address - Street 1:3302 WINDY HILL PT # 3302
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-4132
Practice Address - Country:US
Practice Address - Phone:678-791-2385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHCP011874374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty