Provider Demographics
NPI:1760442735
Name:BARR, JULIE MARIE (CRNA)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:MARIE
Last Name:BARR
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2951 WEST FRONT STREET
Mailing Address - Street 2:SUITE 3050
Mailing Address - City:RICHLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:24641
Mailing Address - Country:US
Mailing Address - Phone:276-963-8504
Mailing Address - Fax:276-963-6642
Practice Address - Street 1:2949 WEST FRONT STREET
Practice Address - Street 2:
Practice Address - City:RICHLANDS
Practice Address - State:VA
Practice Address - Zip Code:24641
Practice Address - Country:US
Practice Address - Phone:276-596-6160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001171436163WG0000X
VA0024166008367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Not Answered367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00128414OtherRAILROAD MEDICARE
VA139686OtherBCBS
WV3810000106Medicaid
VA139686OtherBCBS
WV3810000106Medicaid