Olivia Leann Barker, REGISTERED NURSE
Individual provider Active NPI Gerontology Registered Nurse · Anna, IL
NPI 1255094017 · NPPES record last updated Oct 19, 2021
Key facts
- NPI
- 1255094017
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gerontology Registered Nurse 163WG0600X
- License
- 041490609 (IL)
- Practice address
- 315 Brady Mill Rd
Anna, IL 62906-2306 - Phone
- (618) 833-6343
- NPI assigned
- Oct 19, 2021
- Sex
- Female
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041490609 | IL | MD | Gerontology Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Registered Nurse | 163WG0600X | 041490609 | 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
Other providers in Anna, IL
- Arrowleaf
- Arrowleaf
- Morgan Atherton
- Halley M Barke
- Anthony Shane Barker
- Keith Samuel Bass
- Nancy L Bass
- Steven M Beatty
- Danece Lynn Bennett
- Tessa Lea Binversie
All providers in Anna, IL · Gerontology 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 Oct 19, 2021. 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.