Healthcare Provider Details

I. General information

NPI: 1972286987
Provider Name (Legal Business Name): JOSHUA BARKER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2023
Last Update Date: 08/08/2023
Certification Date: 08/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1898 FORT RD
SHERIDAN WY
82801-8320
US

IV. Provider business mailing address

4 LYRIC DR
RANCHESTER WY
82839-8533
US

V. Phone/Fax

Practice location:
  • Phone: 307-672-3473
  • Fax:
Mailing address:
  • Phone: 307-751-3099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number34027
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: