Provider Demographics
NPI:1699401760
Name:HERRING, BARBARA JOANNA (NP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:JOANNA
Last Name:HERRING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 SWALLOW DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39047-6455
Mailing Address - Country:US
Mailing Address - Phone:850-582-6544
Mailing Address - Fax:
Practice Address - Street 1:1401 LIVINGSTON LN
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39213-8004
Practice Address - Country:US
Practice Address - Phone:850-528-6544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-29
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS905463363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner