Provider Demographics
NPI:1962812743
Name:FALLIS, BARBARA (APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:
Last Name:FALLIS
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 HWY 227
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:KY
Mailing Address - Zip Code:41008-8037
Mailing Address - Country:US
Mailing Address - Phone:502-287-4186
Mailing Address - Fax:502-732-8553
Practice Address - Street 1:1911 HWY 227
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:KY
Practice Address - Zip Code:41008-8037
Practice Address - Country:US
Practice Address - Phone:502-287-4186
Practice Address - Fax:502-732-8553
Is Sole Proprietor?:No
Enumeration Date:2014-05-02
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYF0214366363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily