Provider Demographics
NPI:1154474567
Name:BARKER, ELLEN SLEDGE (RN, CPNP)
Entity type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:SLEDGE
Last Name:BARKER
Suffix:
Gender:F
Credentials:RN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11843 CLARA WAY
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX STATION
Mailing Address - State:VA
Mailing Address - Zip Code:22039-1101
Mailing Address - Country:US
Mailing Address - Phone:703-849-1312
Mailing Address - Fax:703-876-0573
Practice Address - Street 1:8422 ELECTRIC AVE
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-5109
Practice Address - Country:US
Practice Address - Phone:703-849-1312
Practice Address - Fax:703-876-0573
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001101276163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse