Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | SP014885 | PA |
NPI | 1053792275 |
---|---|
Provider Name | Naomi T Barton |
First Address | Philadelphia, PA 19104-4238 |
Second Address | Philadelphia, PA 19104-4238 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2015 |
Last Update Date | 05/04/2016 |