Provider Demographics
NPI:1629564380
Name:BARR, JENNY LYNN
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:LYNN
Last Name:BARR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 N FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:RED CLOUD
Mailing Address - State:NE
Mailing Address - Zip Code:68970-2201
Mailing Address - Country:US
Mailing Address - Phone:402-806-0150
Mailing Address - Fax:
Practice Address - Street 1:30 EPIC BLVD
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-6565
Practice Address - Country:US
Practice Address - Phone:049-217-3881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-05
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE112531363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily