Provider Demographics
NPI:1497794754
Name:BARBER, TIMMY HOWARD (CRNA)
Entity Type:Individual
Prefix:
First Name:TIMMY
Middle Name:HOWARD
Last Name:BARBER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 S MCCASKEY RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTON
Mailing Address - State:NC
Mailing Address - Zip Code:27892-2150
Mailing Address - Country:US
Mailing Address - Phone:865-694-6919
Mailing Address - Fax:865-694-4339
Practice Address - Street 1:310 S MCCASKEY RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:NC
Practice Address - Zip Code:27892-2150
Practice Address - Country:US
Practice Address - Phone:865-694-6919
Practice Address - Fax:865-694-4339
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC79343367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC261014FMedicare ID - Type Unspecified