Provider Demographics
NPI:1003196502
Name:BARKIN, ANITA L (DRPH, MSN)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:L
Last Name:BARKIN
Suffix:
Gender:F
Credentials:DRPH, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 COHEN WALKER DRIVE
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088
Mailing Address - Country:US
Mailing Address - Phone:478-751-6045
Mailing Address - Fax:478-751-6099
Practice Address - Street 1:98 COHEN WALKER DR
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-2729
Practice Address - Country:US
Practice Address - Phone:478-751-6045
Practice Address - Fax:478-751-6099
Is Sole Proprietor?:No
Enumeration Date:2011-08-29
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN238413363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003161295BMedicaid