Provider Demographics
NPI:1093796989
Name:BARTLESON, NANCY J (CNP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:J
Last Name:BARTLESON
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 PARKHURST RD
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-1510
Mailing Address - Country:US
Mailing Address - Phone:978-458-6868
Mailing Address - Fax:978-458-3735
Practice Address - Street 1:85 PARKHURST RD
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-1510
Practice Address - Country:US
Practice Address - Phone:978-458-6868
Practice Address - Fax:978-458-3735
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA107611363LX0001X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NP1761OtherBCBS
MABANP1761Medicare ID - Type Unspecified
S78783Medicare UPIN