Provider Demographics
NPI:1043412257
Name:BILETNIKOFF, BARBARA A (APRN,PNP,C)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:A
Last Name:BILETNIKOFF
Suffix:
Gender:F
Credentials:APRN,PNP,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7750 GREENWELL SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70814-2003
Mailing Address - Country:US
Mailing Address - Phone:225-928-9550
Mailing Address - Fax:225-925-3279
Practice Address - Street 1:7750 GREENWELL SPRINGS RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70814-2003
Practice Address - Country:US
Practice Address - Phone:225-928-9550
Practice Address - Fax:225-925-3279
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN023911APO3901363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1118125Medicaid