Provider Demographics
NPI:1265566301
Name:BARNETT, JONNA M (CFM)
Entity type:Individual
Prefix:MRS
First Name:JONNA
Middle Name:M
Last Name:BARNETT
Suffix:
Gender:F
Credentials:CFM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 923
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-0088
Mailing Address - Country:US
Mailing Address - Phone:317-889-1635
Mailing Address - Fax:317-887-1820
Practice Address - Street 1:850 N MADISON AVE
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-4127
Practice Address - Country:US
Practice Address - Phone:317-889-1635
Practice Address - Fax:317-887-1820
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INCFM00607332B00000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN3872780001Medicare ID - Type UnspecifiedPROVIDER NUMBER