Provider Demographics
NPI:1649629221
Name:BARKER, CELESTE (DNP)
Entity type:Individual
Prefix:
First Name:CELESTE
Middle Name:
Last Name:BARKER
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 N BLUE JAY DR
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-1906
Mailing Address - Country:US
Mailing Address - Phone:816-691-1424
Mailing Address - Fax:816-480-4511
Practice Address - Street 1:109 N BLUE JAY DR
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-1906
Practice Address - Country:US
Practice Address - Phone:816-691-1424
Practice Address - Fax:816-480-4511
Is Sole Proprietor?:No
Enumeration Date:2016-06-06
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016017855363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily