Anthony Shane Barker, RN

Individual provider Active NPI Administrator Registered Nurse · Anna, IL

NPI 1154084986 · NPPES record last updated Oct 19, 2021

Key facts

NPI
1154084986
Entity type
Individual (NPI type 1)
Primary specialty
Administrator Registered Nurse 163WA2000X
License
041393474 (IL)
Practice address
315 Brady Mill Rd
Anna, IL 62906-2306
Phone
(618) 833-6343
Fax
(618) 833-3345
NPI assigned
Oct 19, 2021
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
041393474ILMDAdministrator Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Administrator Registered Nurse 163WA2000X 041393474 IL Yes

Addresses

Primary practice location

315 Brady Mill Rd
Anna, IL 62906-2306

Mailing address

315 Brady Mill Rd
Anna, IL 62906-2306
Phone (618) 833-6343

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address don@annarnc.com Health Information Exchange (HIE)

Other providers in Anna, IL

All providers in Anna, IL · Administrator Registered Nurse in Illinois

Sources for this page

Verify at the official NPI Registry.