Provider Demographics
NPI:1306947817
Name:JOHNSON FARMER, BARBARA JEAN (APNP, FNP, PHD)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:JEAN
Last Name:JOHNSON FARMER
Suffix:
Gender:F
Credentials:APNP, FNP, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6751 W GREENFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53214-4966
Mailing Address - Country:US
Mailing Address - Phone:414-777-5066
Mailing Address - Fax:414-777-5067
Practice Address - Street 1:6751 W GREENFIELD AVE
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53214-4966
Practice Address - Country:US
Practice Address - Phone:414-777-5066
Practice Address - Fax:414-777-5067
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2015-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9302371163W00000X
WI2798-033363LA2200X, 363LF0000X
WI2798-33363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI36001100Medicaid
WIK400162664Medicare PIN
Q59233Medicare UPIN
WI36001100Medicaid
WI010273930Medicare ID - Type UnspecifiedOUTPATIENT