Provider Demographics
NPI:1568563013
Name:BARKER, REBECCA SUSAN (APN)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:SUSAN
Last Name:BARKER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MRS
Other - First Name:SUSAN
Other - Middle Name:SMITH
Other - Last Name:BARKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APN
Mailing Address - Street 1:153 OGEECHEE DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-4763
Mailing Address - Country:US
Mailing Address - Phone:912-727-2254
Mailing Address - Fax:912-921-2000
Practice Address - Street 1:325 W MONTGOMERY XRD
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3309
Practice Address - Country:US
Practice Address - Phone:912-921-2001
Practice Address - Fax:912-921-2000
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN037609363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAVAD000Medicare UPIN