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General NPI Number Information
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NPI Number | 1639878762
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Entity Type | Individual
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Provider Name | JO BARKLEY RN
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Gender | Female
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Dates
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Enumeration Date | 02/27/2023
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Last Update Date | 02/27/2023
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Provider Practice Location Address
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Address Line | 2121 LAKE AVE
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City | FORT WAYNE
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State | IN
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Zip | 46805-5100
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Country | US
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Telephone | 260-460-1445
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Fax |
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Provider Business Mailing Address
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Address Line | 196 N ANNMARIE LN
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City | COLUMBIA CITY
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State | IN
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Zip | 46725-8868
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Country | US
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Telephone | 260-229-0007
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 28153464A
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License Number State | IN
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