Provider Demographics
NPI:1770756652
Name:CHALKER, BARBARA ANN (CRNA)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:CHALKER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 RAINBOW DR # 11333
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77399-2013
Mailing Address - Country:US
Mailing Address - Phone:956-792-4056
Mailing Address - Fax:
Practice Address - Street 1:5200 HARROUN RD
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2168
Practice Address - Country:US
Practice Address - Phone:419-824-1716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-10
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX079519367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2850580Medicaid