Provider Demographics
NPI:1689622698
Name:FIKES-MAKI, BARBARA
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:FIKES-MAKI
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:BLANCHFIELD ARMY COMMUNITY HOSPITAL
Mailing Address - Street 2:650 JOEL DRIVE
Mailing Address - City:FT. CAMPBELL
Mailing Address - State:KY
Mailing Address - Zip Code:42223-5439
Mailing Address - Country:US
Mailing Address - Phone:270-798-8372
Mailing Address - Fax:270-956-0180
Practice Address - Street 1:BLANCHFIELD ARMY COMMUNITY HOSPITAL
Practice Address - Street 2:650 JOEL DRIVE
Practice Address - City:FT. CAMPBELL
Practice Address - State:KY
Practice Address - Zip Code:42223-5439
Practice Address - Country:US
Practice Address - Phone:270-798-8372
Practice Address - Fax:270-956-0180
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12054367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYVAD000Medicare UPIN