Provider Demographics
NPI:1003008681
Name:MARCUM, BARBARA LYNN (RN)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:LYNN
Last Name:MARCUM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 LANG RD POBOX 85
Mailing Address - Street 2:
Mailing Address - City:TWIN LAKES
Mailing Address - State:CO
Mailing Address - Zip Code:81251
Mailing Address - Country:US
Mailing Address - Phone:719-486-9761
Mailing Address - Fax:
Practice Address - Street 1:511 HARRISON
Practice Address - Street 2:
Practice Address - City:LEADVILLE
Practice Address - State:CO
Practice Address - Zip Code:80461
Practice Address - Country:US
Practice Address - Phone:970-389-6457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-16
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO80208163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0780002085Medicaid