Provider Demographics
NPI:1295504488
Name:BARKER, NICKIE JOE
Entity type:Individual
Prefix:MRS
First Name:NICKIE
Middle Name:JOE
Last Name:BARKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7025 STOKER RD
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:OH
Mailing Address - Zip Code:45365-9617
Mailing Address - Country:US
Mailing Address - Phone:937-638-2779
Mailing Address - Fax:
Practice Address - Street 1:7025 STOKER RD
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:OH
Practice Address - Zip Code:45365-9617
Practice Address - Country:US
Practice Address - Phone:937-638-2779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-28
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
385HR2065X
OH385HR2065X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child