Healthcare Provider Details

I. General information

NPI: 1740296755
Provider Name (Legal Business Name): KATRINA BARKER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 11/18/2020
Certification Date: 11/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BELLEFONTE DR STE 2
GRAYSON KY
41143-1820
US

IV. Provider business mailing address

PO BOX 550
VANCEBURG KY
41179-0550
US

V. Phone/Fax

Practice location:
  • Phone: 606-474-0669
  • Fax: 606-474-4009
Mailing address:
  • Phone: 606-956-0162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3003809
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: