1760569735 NPI number — MS. NORMA JEAN BARKER

Table of content: MS. NORMA JEAN BARKER (NPI 1760569735)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760569735 NPI number — MS. NORMA JEAN BARKER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARKER
Provider First Name:
NORMA JEAN
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BARKER
Provider Other First Name:
NORMA JEAN
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
L.M.T.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1760569735
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5251 SE 113TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELLEVIEW
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34420-3933
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-502-4159
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5251 SE 113TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLEVIEW
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34420-3933
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-307-9720
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/01/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  MA15155 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: MA15155 . This is a "MASSAGE LICENSE NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: C-6384 . This is a "BC/BS PROVIDER NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".