Provider Demographics
NPI:1497152367
Name:BARBER, TERRA SUZANNE (CRNA)
Entity Type:Individual
Prefix:MS
First Name:TERRA
Middle Name:SUZANNE
Last Name:BARBER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5737 BAY PINE WAY
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34238-2101
Mailing Address - Country:US
Mailing Address - Phone:469-713-9209
Mailing Address - Fax:
Practice Address - Street 1:1350 E VENICE AVE
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-9066
Practice Address - Country:US
Practice Address - Phone:941-488-2030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-20
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP127284367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered