Provider Demographics
NPI:1912776618
Name:BARKLEY, NOAH ELLIS (FNP)
Entity type:Individual
Prefix:
First Name:NOAH
Middle Name:ELLIS
Last Name:BARKLEY
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 STOCKBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230-1295
Mailing Address - Country:US
Mailing Address - Phone:413-528-8580
Mailing Address - Fax:
Practice Address - Street 1:444 STOCKBRIDGE RD
Practice Address - Street 2:
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-1295
Practice Address - Country:US
Practice Address - Phone:413-528-8580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-22
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2356588363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily