Connie Barber, ANP

Individual provider Active NPI Nurse Practitioner · Portland, OR

NPI 1891787602 · NPPES record last updated Oct 8, 2008

Key facts

NPI
1891787602
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
000031921N3 (OR)
Practice address
2222 NW Lovejoy St
Suite 606
Portland, OR 97210-3033
Phone
(503) 219-8556
Fax
(503) 248-4733
NPI assigned
Aug 17, 2005
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)
Yes
Credentials
Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 000031921N3 OR Yes

Addresses

Primary practice location

2222 NW Lovejoy St
Suite 606
Portland, OR 97210-3033

Mailing address

2222 NW Lovejoy St
Suite 606
Portland, OR 97210-3033
Phone (503) 229-7554

Other identifiers

IdentifierTypeStateIssuer
292349MedicaidOR

Other providers in Portland, OR

All providers in Portland, OR · Nurse Practitioner in Oregon

Sources for this page

Verify at the official NPI Registry.