| |
62 Fork Creek Rd Nellis WV 25142-9737 | |
(304) 833-0815 | |
(304) 833-0030 |
Full Name | |
---|---|
Speciality | Nurse Practitioner |
Location | 62 Fork Creek Rd, Nellis, West Virginia |
Authorized Official Name and Position | Rebecca Ruby Barker (SOLE OWNER; FNP-BC) |
Authorized Official Contact | 3048330815 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
62 Fork Creek Rd Nellis WV 25142-9737 Ph: (304) 833-0815 | 62 Fork Creek Rd Nellis WV 25142-9737 Ph: (304) 833-0815 |
NPI Number | 1487284451 |
---|---|
Provider Enumeration Date | 01/18/2020 |
Last Update Date | 04/05/2022 |
Medicare PECOS PAC ID | 0042649642 |
---|---|
Medicare Enrollment ID | O20200402001856 |
Identifier | Type | State | Issuer |
---|---|---|---|
1487284451 | NPI | - | NPPES |
Provider Name | Rebecca Ruby Barker |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1134472525 PECOS PAC ID: 6608012307 Enrollment ID: I20130425000355 |