Basic Information
Provider Information
NPI: 1235634809
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARBIER
FirstName: TONI
MiddleName: LYNN
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: MARTIN
OtherFirstName: TONI
OtherMiddleName: LYNN
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 902 W MAIN ST
Address2:  
City: WEST FRANKFORT
State: IL
PostalCode: 628962210
CountryCode: US
TelephoneNumber: 6189376483
FaxNumber: 6189371440
Practice Location
Address1: 2615 EDWARDS ST
Address2:  
City: ALTON
State: IL
PostalCode: 620023915
CountryCode: US
TelephoneNumber: 6184622331
FaxNumber: 6184627160
Other Information
ProviderEnumerationDate: 03/27/2018
LastUpdateDate: 03/27/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
164W00000X043.123973ILY Nursing Service ProvidersLicensed Practical Nurse 

No ID Information.


Home