Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | R0098924 | OK |
NPI | 1063180602 |
---|---|
Provider Name | Emillee Barnes |
First Address | Hobart, OK 73651-1615 |
Second Address | Hobart, OK 73651-1645 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2021 |
Last Update Date | 30/08/2021 |