Provider Demographics
NPI:1497910426
Name:CHILDRESS, BARBARA RUTH (RN)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:RUTH
Last Name:CHILDRESS
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:PO BOX 665
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TN
Mailing Address - Zip Code:37371-0665
Mailing Address - Country:US
Mailing Address - Phone:423-745-7431
Mailing Address - Fax:
Practice Address - Street 1:393 COUNTY ROAD 554
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-6420
Practice Address - Country:US
Practice Address - Phone:423-745-7431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-18
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000159679163W00000X
IN28148052A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse