Provider Demographics
NPI:1215460357
Name:BARBER, THOMAS EDWARD (RN)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:EDWARD
Last Name:BARBER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2611 WAYNE AVE UNIT 55
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45420-1833
Mailing Address - Country:US
Mailing Address - Phone:937-256-7801
Mailing Address - Fax:937-303-0990
Practice Address - Street 1:2611 WAYNE AVE
Practice Address - Street 2:BUILDING 64 UNIT 55
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45420-1833
Practice Address - Country:US
Practice Address - Phone:937-256-7801
Practice Address - Fax:937-259-1148
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-05
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH491728163WP0809X, 163WA0400X, 163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)Group - Multi-Specialty
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, AdultGroup - Multi-Specialty