Provider Demographics
NPI:1942591250
Name:BARKER, MELODY DAWN (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:MELODY
Middle Name:DAWN
Last Name:BARKER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:682 E. FM 120
Mailing Address - Street 2:SUITE 8
Mailing Address - City:POTTSBORO
Mailing Address - State:TX
Mailing Address - Zip Code:75076
Mailing Address - Country:US
Mailing Address - Phone:903-786-0141
Mailing Address - Fax:903-786-0141
Practice Address - Street 1:2801 N LOY LAKE RD
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-1726
Practice Address - Country:US
Practice Address - Phone:903-957-0190
Practice Address - Fax:903-957-0188
Is Sole Proprietor?:No
Enumeration Date:2011-04-21
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX717063363LF0000X
TXAP120204363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB163678Medicare PIN
TXTXB163671Medicare PIN
TXTXB163674Medicare PIN