Healthcare Provider Details

I. General information

NPI: 1225775646
Provider Name (Legal Business Name): MAYA BARKER MSAT, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2022
Last Update Date: 05/17/2022
Certification Date: 05/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 N 2ND ST
ATCHISON KS
66002-1402
US

IV. Provider business mailing address

3501 BROOK VIEW DR
DES MOINES IA
50317-4973
US

V. Phone/Fax

Practice location:
  • Phone: 913-367-5340
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: