Healthcare Provider Details

I. General information

NPI: 1457393472
Provider Name (Legal Business Name): ANNE BARKER N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 03/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 SAINT ANDREWS LN
BOOTHBAY HARBOR ME
04538-1732
US

IV. Provider business mailing address

PO BOX 745
NEWCASTLE ME
04553-0745
US

V. Phone/Fax

Practice location:
  • Phone: 207-633-7820
  • Fax: 207-563-4103
Mailing address:
  • Phone: 207-563-4146
  • Fax: 207-563-4103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number045686
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: