Provider Demographics
NPI:1275506107
Name:WREN, BARBARA (MSN)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:WREN
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 LAUREL OAK RD STE 105
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4455
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:856-922-9890
Practice Address - Street 1:707 HADDONFIELD BERLIN RD
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043
Practice Address - Country:US
Practice Address - Phone:856-857-6920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ000344000364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0028649Medicaid
NJP00232125OtherRAILROAD MEDICARE
NJ0028649Medicaid
NJP00232125OtherRAILROAD MEDICARE