Provider Demographics
NPI:1861736795
Name:BARKER, ALICIA MONIQUE L
Entity type:Individual
Prefix:MISS
First Name:ALICIA
Middle Name:MONIQUE L
Last Name:BARKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4225 E BROAD ST
Mailing Address - Street 2:APT 47
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-1270
Mailing Address - Country:US
Mailing Address - Phone:937-546-6314
Mailing Address - Fax:
Practice Address - Street 1:4225 E BROAD ST
Practice Address - Street 2:APT 47
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-1270
Practice Address - Country:US
Practice Address - Phone:937-546-6314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4013110410113747P1801X
OH401211041011376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant