Provider Demographics
NPI:1326264953
Name:KERBY, BARBARA L (NP)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:L
Last Name:KERBY
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:PO BOX 1810
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39502-1810
Mailing Address - Country:US
Mailing Address - Phone:228-867-5185
Mailing Address - Fax:228-867-5189
Practice Address - Street 1:12261 HIGHWAY 49
Practice Address - Street 2:STE 11
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-2975
Practice Address - Country:US
Practice Address - Phone:228-867-5185
Practice Address - Fax:228-867-5189
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12131363LF0000X
MSR878857363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09588582Medicaid