Provider Demographics
NPI:1396394599
Name:BARBER, ASHLEY KAYE (FNP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:KAYE
Last Name:BARBER
Suffix:
Gender:F
Credentials:FNP
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 490
Mailing Address - Street 2:
Mailing Address - City:SEBASTOPOL
Mailing Address - State:MS
Mailing Address - Zip Code:39359-0490
Mailing Address - Country:US
Mailing Address - Phone:601-287-8177
Mailing Address - Fax:601-287-8169
Practice Address - Street 1:17509 HIGHWAY 21
Practice Address - Street 2:
Practice Address - City:SEBASTOPOL
Practice Address - State:MS
Practice Address - Zip Code:39359
Practice Address - Country:US
Practice Address - Phone:601-287-8177
Practice Address - Fax:833-934-3464
Is Sole Proprietor?:No
Enumeration Date:2019-09-10
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS903521363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS06454571Medicaid