Provider Demographics
NPI:1164998662
Name:TARVER, BARBARA ANN (NP-C)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:TARVER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:ANN
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1040 ALEXANDER DR APT 4313
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-0277
Mailing Address - Country:US
Mailing Address - Phone:706-691-6989
Mailing Address - Fax:706-364-6898
Practice Address - Street 1:3642 WHEELER RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-6519
Practice Address - Country:US
Practice Address - Phone:706-496-2573
Practice Address - Fax:706-496-2637
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-23
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAF09180977363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily