MEDICARE: KATHERINE NOEL BARRICKLOW RN FNP

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	363LF0000X	Family Nurse Practitioner	NP09597	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992991509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE NOEL BARRICKLOW RN FNP

Provider Business Mailing Address
First Line	:	1840 E GYPSY LANE RD
Second Line	:
City	:	BOWLING GREEN
State	:	OH
Zip	:	43402-9173
Country	:	US
Telephone Number	:	419-352-8402
Fax Number	:	419-353-1464

Provider Business Practice Location Address
First Line	:	1840 E GYPSY LANE RD
Second Line	:
City	:	BOWLING GREEN
State	:	OH
Zip	:	43402-9173
Country	:	US
Telephone Number	:	419-352-8402
Fax Number	:	419-353-1464

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

Provider Enumeration Date	:	09/18/2007
Last Update Date	:	08/07/2013

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