Provider Demographics
NPI:1326066382
Name:CLICK, BARBARA S (NP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:S
Last Name:CLICK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 E BOW ST
Mailing Address - Street 2:
Mailing Address - City:THORNTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:46071-1164
Mailing Address - Country:US
Mailing Address - Phone:765-436-2400
Mailing Address - Fax:765-436-7573
Practice Address - Street 1:151 E BOW ST
Practice Address - Street 2:
Practice Address - City:THORNTOWN
Practice Address - State:IN
Practice Address - Zip Code:46071-1164
Practice Address - Country:US
Practice Address - Phone:765-436-2400
Practice Address - Fax:765-436-7573
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN72001203A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
230940011OtherMEDICARE
IN200401880Medicaid
IN200401880Medicaid
INP00242091Medicare PIN
IN220170VMedicare PIN