Provider Demographics
NPI:1275886285
Name:STJOHN, BARBARA ANN (NP)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:ANN
Last Name:STJOHN
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 1:20 WILLIAM ST STE G15
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-4102
Mailing Address - Country:US
Mailing Address - Phone:781-591-4234
Mailing Address - Fax:781-369-9737
Practice Address - Street 1:20 WILLIAM ST STE G15
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-4102
Practice Address - Country:US
Practice Address - Phone:781-591-4234
Practice Address - Fax:781-369-9737
Is Sole Proprietor?:No
Enumeration Date:2012-10-16
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN236128363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care