Provider Demographics
NPI:1376251553
Name:BARKER, VICKIE R (RN)
Entity Type:Individual
Prefix:MRS
First Name:VICKIE
Middle Name:R
Last Name:BARKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 STEEL BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:KY
Mailing Address - Zip Code:41124-8413
Mailing Address - Country:US
Mailing Address - Phone:606-369-0889
Mailing Address - Fax:
Practice Address - Street 1:289 STEEL BRANCH RD
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:KY
Practice Address - Zip Code:41124-8413
Practice Address - Country:US
Practice Address - Phone:606-369-0889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1063628163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000Medicaid