Provider Demographics
NPI:1932489465
Name:BARBER, SHIRLEY LARAINE
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:LARAINE
Last Name:BARBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 HOLLAND AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-2631
Mailing Address - Country:US
Mailing Address - Phone:702-788-1175
Mailing Address - Fax:
Practice Address - Street 1:412 HOLLAND AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-2631
Practice Address - Country:US
Practice Address - Phone:702-788-1175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist