Provider Demographics
NPI:1265961312
Name:BARKER, REBECCA M (CRNP)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:M
Last Name:BARKER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9419 FARMINGDALE AVE
Mailing Address - Street 2:
Mailing Address - City:WALKERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21793-9118
Mailing Address - Country:US
Mailing Address - Phone:443-695-3495
Mailing Address - Fax:
Practice Address - Street 1:182 THOMAS JOHNSON DR STE 100
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4486
Practice Address - Country:US
Practice Address - Phone:301-668-0002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-11
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR209130363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily