Provider Demographics
NPI:1376001164
Name:JOSEPH, BARBARA LYNN (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:LYNN
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5107 HWY 406
Mailing Address - Street 2:
Mailing Address - City:STINNETT
Mailing Address - State:KY
Mailing Address - Zip Code:40868
Mailing Address - Country:US
Mailing Address - Phone:606-374-3662
Mailing Address - Fax:
Practice Address - Street 1:5107 HWY 406
Practice Address - Street 2:
Practice Address - City:STINNETT
Practice Address - State:KY
Practice Address - Zip Code:40868
Practice Address - Country:US
Practice Address - Phone:606-374-3662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-11
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3013295363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1121293Medicaid