Healthcare Provider Details

I. General information

NPI: 1215807441
Provider Name (Legal Business Name): TERESA LYNN BARKER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2025
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2204 WILBORN AVE
SOUTH BOSTON VA
24592-1645
US

IV. Provider business mailing address

2204 WILBORN AVE
SOUTH BOSTON VA
24592-1645
US

V. Phone/Fax

Practice location:
  • Phone: 434-572-8977
  • Fax:
Mailing address:
  • Phone: 434-572-8977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001213848
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024195211
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: