Healthcare Provider Details

I. General information

NPI: 1568563013
Provider Name (Legal Business Name): REBECCA SUSAN BARKER APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUSAN SMITH BARKER APN

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 W MONTGOMERY XRD
SAVANNAH GA
31406-3309
US

IV. Provider business mailing address

153 OGEECHEE DR
RICHMOND HILL GA
31324-4763
US

V. Phone/Fax

Practice location:
  • Phone: 912-921-2001
  • Fax: 912-921-2000
Mailing address:
  • Phone: 912-727-2254
  • Fax: 912-921-2000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN037609
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: