Barbara Lynn Dierking
Individual provider Active NPI Medical-Surgical Registered Nurse · Godfrey, IL
NPI 1235697491 · NPPES record last updated Jun 11, 2019
Key facts
- NPI
- 1235697491
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical-Surgical Registered Nurse 163WM0705X
- License
- 2015032726 (MO)
- Practice address
- 5700 Piasa TRL
Godfrey, IL 62035-1030 - Phone
- (618) 946-6126
- NPI assigned
- Mar 6, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2015032726 | MO | MD | Medical-Surgical Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical-Surgical Registered Nurse | 163WM0705X | 2015032726 | MO | Yes |
Addresses
Primary practice location
5700 Piasa TRL
Godfrey, IL 62035-1030
Mailing address
5700 Piasa TRL
Godfrey, IL 62035-1030
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2015032726 | Other | MO | RN LICENSE |
Other names
- Barbara Lynn Crawford
Other providers in Godfrey, IL
- Kristin Anne Childers
- Clarkson Optometry Illinois, P.C.
- Community College District 536
- Kristine M Costello
- Larry Wayne Crocker
- Allison Marie Doyle
- Dr. Kimberly D. Haug, PC
- Tracy Dawn Ducey
- Stephanie Duke
- Elaine Edwards
All providers in Godfrey, IL · Medical-Surgical Registered Nurse in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 11, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.