Provider Demographics
NPI:1265826093
Name:ERVIN, BARBARA (APRN)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:ERVIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 E QUARTER RD
Mailing Address - Street 2:
Mailing Address - City:SILOAM SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72761-4591
Mailing Address - Country:US
Mailing Address - Phone:479-238-1222
Mailing Address - Fax:
Practice Address - Street 1:1700 E QUARTER RD
Practice Address - Street 2:
Practice Address - City:SILOAM SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72761-4591
Practice Address - Country:US
Practice Address - Phone:479-238-1222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-18
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR225136363LA2100X, 363LF0000X, 363L00000X
MO2024005896363LA2100X
MO2024005897363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily