Provider Demographics
NPI:1346049558
Name:MERA, BARBARA JULIETTE
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:JULIETTE
Last Name:MERA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 W WILLOWLAKE DR APT 301
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61614-1172
Mailing Address - Country:US
Mailing Address - Phone:305-733-5264
Mailing Address - Fax:
Practice Address - Street 1:2700 W WILLOWLAKE DR APT 301
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61614-1172
Practice Address - Country:US
Practice Address - Phone:305-733-5264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program