Provider Demographics
NPI:1992918114
Name:KING, BARBARA E (FNP-BC)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:E
Last Name:KING
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:E
Other - Last Name:BOWEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9513 HIGHWAY 100
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:MO
Mailing Address - Zip Code:63068-1300
Mailing Address - Country:US
Mailing Address - Phone:573-237-6100
Mailing Address - Fax:
Practice Address - Street 1:9513 HIGHWAY 100
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:MO
Practice Address - Zip Code:63068-1300
Practice Address - Country:US
Practice Address - Phone:573-237-6100
Practice Address - Fax:573-237-6101
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2018-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO095905363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO424594307Medicaid
P69116Medicare UPIN
818782943Medicare PIN