Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | A089550 | IA |
NPI | 1003268228 |
---|---|
Provider Name | Barbara Jo Masters |
First Address | Corydon, IA 50060-1860 |
Second Address | Lineville, IA 50147-8517 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2016 |
Last Update Date | 07/01/2019 |