MEDICARE: REBECCA BARBER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	5013205	NC
2	363LF0000X	Family Nurse Practitioner	R165300	MD

General Provider Information

NPI Number	:	1932434834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA BARBER

Provider Business Mailing Address
First Line	:	25 N HAMPSTEAD VILLAGE DR
Second Line	:
City	:	HAMPSTEAD
State	:	NC
Zip	:	28443-3932
Country	:	US
Telephone Number	:	612-225-1538
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 N HAMPSTEAD VILLAGE DR
Second Line	:
City	:	HAMPSTEAD
State	:	NC
Zip	:	28443-3932
Country	:	US
Telephone Number	:	910-803-0340
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2009
Last Update Date	:	02/24/2025

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