Provider Demographics
NPI:1427812783
Name:BARKER, JENNIE (FNP-BC)
Entity type:Individual
Prefix:
First Name:JENNIE
Middle Name:
Last Name:BARKER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12574 ANGELINA DR
Mailing Address - Street 2:
Mailing Address - City:PEYTON
Mailing Address - State:CO
Mailing Address - Zip Code:80831-8468
Mailing Address - Country:US
Mailing Address - Phone:702-403-0526
Mailing Address - Fax:
Practice Address - Street 1:412 N C ST
Practice Address - Street 2:
Practice Address - City:CRIPPLE CREEK
Practice Address - State:CO
Practice Address - Zip Code:80813-5052
Practice Address - Country:US
Practice Address - Phone:719-820-7740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0999503-NP207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine