Provider Demographics
NPI:1023660792
Name:BARBER, JUNE BROUILLARD (NP)
Entity type:Individual
Prefix:
First Name:JUNE
Middle Name:BROUILLARD
Last Name:BARBER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JUNE
Other - Middle Name:
Other - Last Name:BARBER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:200 CORPORATE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-3870
Mailing Address - Country:US
Mailing Address - Phone:800-893-9698
Mailing Address - Fax:
Practice Address - Street 1:99 E STATE ST
Practice Address - Street 2:
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078-1293
Practice Address - Country:US
Practice Address - Phone:518-725-8621
Practice Address - Fax:518-773-5669
Is Sole Proprietor?:No
Enumeration Date:2019-07-12
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY344938363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner