Provider Demographics
NPI:1518916949
Name:BYRD, BARBARA DARLENE (APN)
Entity Type:Individual
Prefix:MISS
First Name:BARBARA
Middle Name:DARLENE
Last Name:BYRD
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 TAHOE CT
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023-2883
Mailing Address - Country:US
Mailing Address - Phone:501-605-8110
Mailing Address - Fax:
Practice Address - Street 1:14 TAHOE CT
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-2883
Practice Address - Country:US
Practice Address - Phone:501-605-8110
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA01161363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARR18622Medicare UPIN
AR5S846Medicare ID - Type Unspecified