Provider Demographics
NPI:1326936246
Name:BARNES, LYDENA
Entity type:Individual
Prefix:
First Name:LYDENA
Middle Name:
Last Name:BARNES
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 1:11433 W FLORIST AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53225-2318
Mailing Address - Country:US
Mailing Address - Phone:414-426-4392
Mailing Address - Fax:
Practice Address - Street 1:11433 W FLORIST AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53225-2318
Practice Address - Country:US
Practice Address - Phone:414-426-4392
Practice Address - Fax:414-426-4392
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide