Provider Demographics
NPI:1710438064
Name:BARBER, HEATHER NICOLE
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:NICOLE
Last Name:BARBER
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:HEATHER
Other - Middle Name:NICOLE
Other - Last Name:LYLES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:17221 SUNNY HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-6769
Mailing Address - Country:US
Mailing Address - Phone:405-888-9803
Mailing Address - Fax:
Practice Address - Street 1:17221 SUNNY HOLLOW RD
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73012-6769
Practice Address - Country:US
Practice Address - Phone:405-888-9803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-21
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator