Provider Demographics
NPI:1114195187
Name:BARR, PAULA G (FNP)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:G
Last Name:BARR
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 1:1201 N RUTHERFORD ST
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:MO
Mailing Address - Zip Code:63552-2020
Mailing Address - Country:US
Mailing Address - Phone:660-385-8901
Mailing Address - Fax:660-385-8708
Practice Address - Street 1:1201 N RUTHERFORD ST
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:MO
Practice Address - Zip Code:63552-2020
Practice Address - Country:US
Practice Address - Phone:660-385-8901
Practice Address - Fax:660-385-8708
Is Sole Proprietor?:No
Enumeration Date:2008-02-13
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOAPPLIED FOR363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily