Provider Demographics
NPI:1063192748
Name:BARKER, REBECCA NICOLE
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:NICOLE
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 1:211 MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:LOST CREEK
Mailing Address - State:WV
Mailing Address - Zip Code:26385-7120
Mailing Address - Country:US
Mailing Address - Phone:304-626-0982
Mailing Address - Fax:
Practice Address - Street 1:445 W MAIN ST STE 212
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:WV
Practice Address - Zip Code:26301-2843
Practice Address - Country:US
Practice Address - Phone:304-842-0200
Practice Address - Fax:304-842-8341
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide