Provider Demographics
NPI:1689616336
Name:BARBER, JAMISON R (GNP)
Entity Type:Individual
Prefix:
First Name:JAMISON
Middle Name:R
Last Name:BARBER
Suffix:
Gender:F
Credentials:GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55415-1623
Mailing Address - Country:US
Mailing Address - Phone:612-873-6005
Mailing Address - Fax:612-630-8242
Practice Address - Street 1:701 PARK AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55415-1623
Practice Address - Country:US
Practice Address - Phone:612-873-2720
Practice Address - Fax:612-904-4243
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN320406-23363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN019M6BAOtherBLUE CROSS BLUE SHIELD
MN04-03990OtherMEDICA
MN500025912OtherMEDICARE RAILROAD
MN534122100Medicaid
MN019M6BAOtherBLUE CROSS BLUE SHIELD
MNS97873Medicare UPIN
MN500025912OtherMEDICARE RAILROAD