Healthcare Provider Details

I. General information

NPI: 1942550751
Provider Name (Legal Business Name): JUDY M. BARKER RN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2012
Last Update Date: 09/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 CUMMINGS HILL RD
TEMPLE ME
04984-0311
US

IV. Provider business mailing address

90 CUMMINGS HILL RD
TEMPLE ME
04984-0311
US

V. Phone/Fax

Practice location:
  • Phone: 207-446-0128
  • Fax:
Mailing address:
  • Phone: 207-446-0128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number033695
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: