Provider Demographics
NPI:1164506119
Name:KING, BARBARA JEANNETTE (RN)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:JEANNETTE
Last Name:KING
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:BARBARA
Other - Middle Name:JEANNETTE
Other - Last Name:ACSELROD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4TH & INNER LOOP
Mailing Address - Street 2:
Mailing Address - City:FORT IRWIN
Mailing Address - State:CA
Mailing Address - Zip Code:92310-5109
Mailing Address - Country:US
Mailing Address - Phone:760-380-6292
Mailing Address - Fax:760-380-4213
Practice Address - Street 1:4TH & INNER LOOP
Practice Address - Street 2:
Practice Address - City:FORT IRWIN
Practice Address - State:CA
Practice Address - Zip Code:92310-5109
Practice Address - Country:US
Practice Address - Phone:760-380-6292
Practice Address - Fax:760-380-4213
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00072515163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse