Provider Demographics
NPI:1992991509
Name:BARRICKLOW, KATHERINE NOEL (RN FNP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:NOEL
Last Name:BARRICKLOW
Suffix:
Gender:F
Credentials:RN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 E GYPSY LANE RD
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-9173
Mailing Address - Country:US
Mailing Address - Phone:419-352-8402
Mailing Address - Fax:419-353-1464
Practice Address - Street 1:1840 E GYPSY LANE RD
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-9173
Practice Address - Country:US
Practice Address - Phone:419-352-8402
Practice Address - Fax:419-353-1464
Is Sole Proprietor?:No
Enumeration Date:2007-09-18
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP09597363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2836346Medicaid
OH2836346Medicaid