Basic Information
Provider Information
NPI: 1831272079
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARBOUR
FirstName: KRISTA
MiddleName: A.
NamePrefix:  
NameSuffix:  
Credential: PHD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: DUKE UNIVERSITY MEDICAL CTR
Address2: DUMC 3119
City: DURHAM
State: NC
PostalCode: 277100001
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 4101 N ROXBORO ST
Address2:  
City: DURHAM
State: NC
PostalCode: 277042121
CountryCode: US
TelephoneNumber: 9196848111
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/23/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X2957NCY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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