Provider Demographics
NPI:1932628666
Name:BARBER, KATRECE J (NP)
Entity type:Individual
Prefix:MRS
First Name:KATRECE
Middle Name:J
Last Name:BARBER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:KATRECE
Other - Middle Name:J
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9544 W TAMPA DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70815-8952
Mailing Address - Country:US
Mailing Address - Phone:225-223-7780
Mailing Address - Fax:
Practice Address - Street 1:10310 THE GROVE BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70836-6455
Practice Address - Country:US
Practice Address - Phone:225-761-5200
Practice Address - Fax:225-761-5425
Is Sole Proprietor?:No
Enumeration Date:2017-09-13
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP09562363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LANONEOtherALL ARE APPLIED FOR