Provider Demographics
NPI:1720236771
Name:BARKER, ANNE MELINDA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:MELINDA
Last Name:BARKER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 BROAD ST
Mailing Address - Street 2:PO BOX 175
Mailing Address - City:BAXTER
Mailing Address - State:TN
Mailing Address - Zip Code:38544-5117
Mailing Address - Country:US
Mailing Address - Phone:931-858-2116
Mailing Address - Fax:931-858-2117
Practice Address - Street 1:319 BROAD ST
Practice Address - Street 2:
Practice Address - City:BAXTER
Practice Address - State:TN
Practice Address - Zip Code:38544-5117
Practice Address - Country:US
Practice Address - Phone:931-858-2116
Practice Address - Fax:931-858-2117
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000013608363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1507279Medicaid
TN1507279Medicaid