Provider Demographics
NPI:1710967492
Name:BARKER, LINDA A (PA)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:A
Last Name:BARKER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W PEACH ST
Mailing Address - Street 2:
Mailing Address - City:MARTIN
Mailing Address - State:TN
Mailing Address - Zip Code:38237-3949
Mailing Address - Country:US
Mailing Address - Phone:731-587-2525
Mailing Address - Fax:731-587-2555
Practice Address - Street 1:300 W PEACH ST
Practice Address - Street 2:
Practice Address - City:MARTIN
Practice Address - State:TN
Practice Address - Zip Code:38237-3949
Practice Address - Country:US
Practice Address - Phone:731-587-2525
Practice Address - Fax:731-587-2555
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA1062363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3662597Medicaid
TN5198560001Medicare NSC
TN0003725672Medicare NSC
TNQ04765Medicare UPIN
TN3662597Medicaid