Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | RN238413 | GA |
NPI | 1003196502 |
---|---|
Provider Name | Anita L. Barkin |
First Address | Warner Robins, GA 31088 |
Second Address | Warner Robins, GA 31088-2729 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2011 |
Last Update Date | 27/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003161295B | (05) | GA |