Basic Information
Provider Information
NPI: 1457393472
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARKER
FirstName: ANNE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: N.P.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 745
Address2:  
City: NEWCASTLE
State: ME
PostalCode: 045530745
CountryCode: US
TelephoneNumber: 2075634146
FaxNumber: 2075634103
Practice Location
Address1: 19 SAINT ANDREWS LN
Address2:  
City: BOOTHBAY HARBOR
State: ME
PostalCode: 045381732
CountryCode: US
TelephoneNumber: 2076337820
FaxNumber: 2075634103
Other Information
ProviderEnumerationDate: 06/12/2006
LastUpdateDate: 03/16/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X045686MEY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

ID Information
IDTypeStateIssuerDescription
33450009905ME MEDICAID


Home