MEDICARE: TIMMY HOWARD BARBER CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	79343	NC

General Provider Information

NPI Number	:	1497794754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMMY HOWARD BARBER CRNA

Provider Business Mailing Address
First Line	:	310 S MCCASKEY RD
Second Line	:
City	:	WILLIAMSTON
State	:	NC
Zip	:	27892-2150
Country	:	US
Telephone Number	:	865-694-6919
Fax Number	:	865-694-4339

Provider Business Practice Location Address
First Line	:	310 S MCCASKEY RD
Second Line	:
City	:	WILLIAMSTON
State	:	NC
Zip	:	27892-2150
Country	:	US
Telephone Number	:	865-694-6919
Fax Number	:	865-694-4339

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	09/12/2018

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