Provider Demographics
NPI:1154076412
Name:BARBULA, LORI (NP)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:BARBULA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5813 S DAME DR
Mailing Address - Street 2:
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85622-0017
Mailing Address - Country:US
Mailing Address - Phone:719-332-1523
Mailing Address - Fax:
Practice Address - Street 1:8616 E BROADWAY BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-4014
Practice Address - Country:US
Practice Address - Phone:520-468-4809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-15
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRNP270830363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZRNP270830OtherBOARD OF NURSING FOR ADVANCE PRACTICE