Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 01061711A | IN |
NPI | 1013118736 |
---|---|
Provider Name | Dr. Jennifer Rae Barker |
First Address | Indianapolis, IN 46202 |
Second Address | Indianapolis, IN 46202-5128 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2007 |
Last Update Date | 10/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2009632640 | (05) | IN |