Provider Demographics
NPI:1730108176
Name:BARKER, EARLENE (ARNP)
Entity Type:Individual
Prefix:
First Name:EARLENE
Middle Name:
Last Name:BARKER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 ROLAND AVE
Mailing Address - Street 2:
Mailing Address - City:OWENTON
Mailing Address - State:KY
Mailing Address - Zip Code:40359-1502
Mailing Address - Country:US
Mailing Address - Phone:502-484-3663
Mailing Address - Fax:502-484-8332
Practice Address - Street 1:330 ROLAND AVE
Practice Address - Street 2:
Practice Address - City:OWENTON
Practice Address - State:KY
Practice Address - Zip Code:40359-1502
Practice Address - Country:US
Practice Address - Phone:502-484-3663
Practice Address - Fax:502-484-8332
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2344P282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYS48149Medicare UPIN