Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 2018089166 | NC |
NPI | 1003374208 |
---|---|
Provider Name | Elizabeth Barton |
First Address | Shallotte, NC 28459-1585 |
Second Address | Shallotte, NC 28470-6501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2019 |
Last Update Date | 06/03/2019 |