Basic Information
Provider Information
NPI: 1750816237
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARKER
FirstName: CASEY
MiddleName: ELIZABETH
NamePrefix:  
NameSuffix:  
Credential: APRN, FNP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SCHWANTES
OtherFirstName: CASEY
OtherMiddleName: ELIZABETH
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 400 13TH AVE S STE 206
Address2:  
City: GREAT FALLS
State: MT
PostalCode: 594054300
CountryCode: US
TelephoneNumber: 4067318888
FaxNumber: 4067318318
Practice Location
Address1: 400 13TH AVE S STE 206
Address2:  
City: GREAT FALLS
State: MT
PostalCode: 594054300
CountryCode: US
TelephoneNumber: 4067318888
FaxNumber: 4067318318
Other Information
ProviderEnumerationDate: 04/21/2017
LastUpdateDate: 03/29/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/29/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XNUR-APRN-LIC-127605MTY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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