Basic Information
Provider Information
NPI: 1225166309
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARBER
FirstName: NANCY
MiddleName: LOUISE
NamePrefix: DR.
NameSuffix:  
Credential: DNSC, APRNBC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 522 EYSIAN DR
Address2:  
City: CLARKSVILLE
State: TN
PostalCode: 370406581
CountryCode: US
TelephoneNumber: 9316473865
FaxNumber:  
Practice Location
Address1: 511 8TH ST
Address2:  
City: CLARKSVILLE
State: TN
PostalCode: 370403093
CountryCode: US
TelephoneNumber: 9319207200
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/01/2007
LastUpdateDate: 07/09/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0808XAPN6604TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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