Provider Demographics
NPI:1568700409
Name:NEFSTEAD, BARBARA MARIANNE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:MARIANNE
Last Name:NEFSTEAD
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:MARIANNE
Other - Last Name:ILLGNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3955 COUNTY ROAD G
Mailing Address - Street 2:
Mailing Address - City:DALHART
Mailing Address - State:TX
Mailing Address - Zip Code:79022-7701
Mailing Address - Country:US
Mailing Address - Phone:806-683-7937
Mailing Address - Fax:
Practice Address - Street 1:22 CARE CIR
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79124-2118
Practice Address - Country:US
Practice Address - Phone:806-354-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-28
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX681099363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health