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General NPI Number Information
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NPI Number | 1992081491
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Entity Type | Individual
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Provider Name | JODY A BARHAM APN
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Gender | Male
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Dates
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Enumeration Date | 10/27/2011
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 2118 N STATE LINE AVE
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City | TEXARKANA
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State | AR
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Zip | 71854-3583
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Country | US
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Telephone | 870-703-7764
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Fax |
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Provider Business Mailing Address
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Address Line | 2118 N STATE LINE AVE
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City | TEXARKANA
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State | AR
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Zip | 71854-3583
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Country | US
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Telephone |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | A03610
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP135878
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License Number State | TX
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