Provider Demographics
NPI:1902040686
Name:BARTON, TESSA JO (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:TESSA
Middle Name:JO
Last Name:BARTON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MISS
Other - First Name:TESSA
Other - Middle Name:JO
Other - Last Name:MCFARLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4002 TECHNOLOGY CTR
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-2697
Mailing Address - Country:US
Mailing Address - Phone:903-247-0484
Mailing Address - Fax:903-247-0485
Practice Address - Street 1:2019A S HENDERSON BLVD STE 4
Practice Address - Street 2:
Practice Address - City:KILGORE
Practice Address - State:TX
Practice Address - Zip Code:75662-3565
Practice Address - Country:US
Practice Address - Phone:903-988-0605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-27
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX671577363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX671577OtherSTATE LIC #