Provider Demographics
NPI:1487492393
Name:BARKER, NATHAN (LP)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:
Last Name:BARKER
Suffix:
Gender:M
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3103 MAPLEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50014-4572
Mailing Address - Country:US
Mailing Address - Phone:319-217-8842
Mailing Address - Fax:
Practice Address - Street 1:4720 MORTENSEN RD STE 101
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50014-5534
Practice Address - Country:US
Practice Address - Phone:515-599-8904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA121907103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist