Provider Demographics
NPI:1265911523
Name:BARKER, MANDY LYNNE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:MANDY
Middle Name:LYNNE
Last Name:BARKER
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
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Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:318-966-8666
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:711 SAINT JOHN ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-8435
Practice Address - Country:US
Practice Address - Phone:318-966-8666
Practice Address - Fax:318-966-8667
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2023-07-17
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Provider Licenses
StateLicense IDTaxonomies
LAAP10148363LW0102X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health