Provider Demographics
NPI:1871966739
Name:AGNEW, BARBARA ELAINE (LPN)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:ELAINE
Last Name:AGNEW
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 DEER CREEK RD
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-4148
Mailing Address - Country:US
Mailing Address - Phone:585-967-0911
Mailing Address - Fax:
Practice Address - Street 1:82 DEER CREEK RD
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-4148
Practice Address - Country:US
Practice Address - Phone:585-967-0911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-01
Last Update Date:2015-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225470-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse