Healthcare Provider Details

I. General information

NPI: 1427965979
Provider Name (Legal Business Name): JENNY BARBERA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 E PEARL AVE
JACKSON WY
83001-8410
US

IV. Provider business mailing address

4101 S MUSTANG DR
JACKSON WY
83001-8967
US

V. Phone/Fax

Practice location:
  • Phone: 307-733-6401
  • Fax: 307-733-8747
Mailing address:
  • Phone: 518-598-7321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number35694
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: