Provider Demographics
NPI:1073851598
Name:BARR, BETTY A (PA-C)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:A
Last Name:BARR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:BETTY
Other - Middle Name:A
Other - Last Name:BRALEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 390
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25708-0390
Mailing Address - Country:US
Mailing Address - Phone:304-429-1088
Mailing Address - Fax:304-354-5963
Practice Address - Street 1:303 MAIN ST
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:WV
Practice Address - Zip Code:25276-1313
Practice Address - Country:US
Practice Address - Phone:304-927-7775
Practice Address - Fax:304-927-7774
Is Sole Proprietor?:No
Enumeration Date:2013-01-17
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
WV01696363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant