Provider Demographics
NPI:1639494636
Name:BARRU, HENRY J (LAC, RN)
Entity type:Individual
Prefix:MR
First Name:HENRY
Middle Name:J
Last Name:BARRU
Suffix:
Gender:M
Credentials:LAC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 6TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21060-6828
Mailing Address - Country:US
Mailing Address - Phone:443-850-2733
Mailing Address - Fax:
Practice Address - Street 1:404 6TH AVE NE
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21060-6828
Practice Address - Country:US
Practice Address - Phone:443-850-2733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-01
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01462171100000X
MDR113773163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No163W00000XNursing Service ProvidersRegistered Nurse