Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | SW 7322 | FL |
N | 363LC1500X | Nurse Practitioner - Community Health | ARNP 9203658 | FL |
NPI | 1730219254 |
---|---|
Provider Name | Dr. Barbara Ann Mcdermid |
First Address | Port St Joe, FL 32456-5265 |
Second Address | Port St Joe, FL 32456-5265 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2007 |
Last Update Date | 02/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
308654200 | (05) | FL |
Z054Q | BLUE CROSS BLUE SHIELD AS LCSW (01) | FL |