Provider Demographics
NPI:1053957548
Name:BARKER, JEAN NOEL (PA-C)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:NOEL
Last Name:BARKER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:NOEL
Other - Last Name:ESCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:13451 W KINLEY RD
Mailing Address - Street 2:
Mailing Address - City:FOWLER
Mailing Address - State:MI
Mailing Address - Zip Code:48835-9237
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:900 COOPER AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-5182
Practice Address - Country:US
Practice Address - Phone:989-583-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-20
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601009567363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant