Provider Demographics
NPI:1033123278
Name:BARNARD, THERESA LYNN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:LYNN
Last Name:BARNARD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 52119
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27717-2119
Mailing Address - Country:US
Mailing Address - Phone:919-956-4015
Mailing Address - Fax:919-956-4535
Practice Address - Street 1:807 S DUKE ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-3975
Practice Address - Country:US
Practice Address - Phone:919-956-5386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704232418163W00000X
NC5004124363LF0000X
NC223141163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR133879OtherNAS MEDICARE PART B
OR133880OtherNAS MEDICARE PART B
WA8858358OtherNAS MEDICARE PART B
OR133878OtherNAS MEDICARE PART B
NC2593396Medicare UPIN
ORQ64265Medicare UPIN
NCQ64265Medicare PIN