Healthcare Provider Details

I. General information

NPI: 1447658851
Provider Name (Legal Business Name): EMILY BARKER APRN, DNP, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2014
Last Update Date: 03/10/2024
Certification Date: 03/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1709 JUMER DR STE A
BLOOMINGTON IL
61704-0914
US

IV. Provider business mailing address

1709 JUMER DR STE A
BLOOMINGTON IL
61704-0914
US

V. Phone/Fax

Practice location:
  • Phone: 309-273-1098
  • Fax:
Mailing address:
  • Phone: 309-273-1098
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number209024282
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number041320633
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: