Provider Demographics
NPI:1962641399
Name:BARKER, KATHRYN CORINNE (ANP-BC)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:CORINNE
Last Name:BARKER
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 N PASS AVE
Mailing Address - Street 2:APT 36
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-3338
Mailing Address - Country:US
Mailing Address - Phone:818-433-7514
Mailing Address - Fax:
Practice Address - Street 1:2000 OUTLET CENTER DR
Practice Address - Street 2:STE 220
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-0607
Practice Address - Country:US
Practice Address - Phone:312-804-5125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18751363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health