Provider Demographics
NPI:1346201936
Name:BARGO, BARBARA (ARNP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:BARGO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4671 S US HIGHWAY 25 E
Mailing Address - Street 2:
Mailing Address - City:BIMBLE
Mailing Address - State:KY
Mailing Address - Zip Code:40915
Mailing Address - Country:US
Mailing Address - Phone:606-546-2598
Mailing Address - Fax:606-545-0497
Practice Address - Street 1:4671 S US HIGHWAY 25 E
Practice Address - Street 2:
Practice Address - City:BIMBLE
Practice Address - State:KY
Practice Address - Zip Code:40915
Practice Address - Country:US
Practice Address - Phone:606-546-2598
Practice Address - Fax:606-545-0497
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2774P363LP0808X, 363LP0808X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78277407Medicaid
KY0779705Medicare ID - Type Unspecified
KYP92279Medicare UPIN