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General NPI Number Information
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NPI Number | 1962746131
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Entity Type | Individual
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Provider Name | TARA JEAN BARNES
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Gender | Female
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Dates
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Enumeration Date | 11/12/2012
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Last Update Date | 05/16/2024
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Provider Practice Location Address
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Address Line | 7777 E US HIGHWAY 66
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City | EL RENO
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State | OK
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Zip | 73036-9125
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Country | US
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Telephone | 405-424-7711
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Fax |
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Provider Business Mailing Address
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Address Line | 7777 EAST HIGHWAY
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City | EL RENO
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State | OK
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Zip | 73036-9116
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Country | US
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Telephone | 405-425-0452
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Fax | 580-323-0828
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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 | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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