Healthcare Provider Details

I. General information

NPI: 1801177720
Provider Name (Legal Business Name): JONI E BARKER APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2011
Last Update Date: 12/14/2022
Certification Date: 12/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

904 AUTUMN RD STE 200
LITTLE ROCK AR
72211-3741
US

IV. Provider business mailing address

904 AUTUMN RD STE 200
LITTLE ROCK AR
72211-3741
US

V. Phone/Fax

Practice location:
  • Phone: 501-227-6363
  • Fax: 501-227-8629
Mailing address:
  • Phone: 501-227-6363
  • Fax: 501-227-8629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA003543
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: