Provider Demographics
NPI:1023158763
Name:PEARCE, BARBARA ANN (ANP-C)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ANN
Last Name:PEARCE
Suffix:
Gender:F
Credentials:ANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4233 CAMELOT XING
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-6926
Mailing Address - Country:US
Mailing Address - Phone:229-469-4383
Mailing Address - Fax:229-469-4584
Practice Address - Street 1:4233 CAMELOT XING
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-6926
Practice Address - Country:US
Practice Address - Phone:229-469-4383
Practice Address - Fax:229-469-4584
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN054555 NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00741914BMedicaid
GA00741914BMedicaid
GAS48329Medicare UPIN