Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | APN0001635CNP | CO |
N | 363LA2100X | Nurse Practitioner - Acute Care | 83548 | OK |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 83548 | OK |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | R0083548 | OK |
NPI | 1043248701 |
---|---|
Provider Name | Dr. Jeffery David Barlow |
First Address | Moore, OK 73153-9998 |
Second Address | Moore, OK 73160-5420 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 04/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200523800 | (05) | OK |