Basic Information
| Provider Information | |||||||||
| NPI: | 1700913100 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARBER | ||||||||
| FirstName: | DIANE | ||||||||
| MiddleName: | LOUISE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 305 MEDIC WAY | ||||||||
| Address2: | |||||||||
| City: | GREENCASTLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461352296 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7656534633 | ||||||||
| FaxNumber: | 7656530562 | ||||||||
| Practice Location | |||||||||
| Address1: | 305 MEDIC WAY | ||||||||
| Address2: | |||||||||
| City: | GREENCASTLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461352296 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7656534633 | ||||||||
| FaxNumber: | 7656530562 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/27/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 10000306A | IN | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.