Provider Demographics
NPI:1013931732
Name:BARKER, JAMMIE L (RN MSN ARNP FNP-BC)
Entity Type:Individual
Prefix:
First Name:JAMMIE
Middle Name:L
Last Name:BARKER
Suffix:
Gender:F
Credentials:RN MSN ARNP FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 BILL OWENS PKWY
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75604-6210
Mailing Address - Country:US
Mailing Address - Phone:903-247-3400
Mailing Address - Fax:903-238-9183
Practice Address - Street 1:2010 BILL OWENS PKWY
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75604-6210
Practice Address - Country:US
Practice Address - Phone:903-247-3400
Practice Address - Fax:903-238-9183
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK46651363LF0000X
TX559894363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK243603001Medicaid
OKQ62213Medicare UPIN
OK243603001Medicaid