Provider Demographics
NPI:1316205974
Name:BARRON, TABITHA DAWN (NP)
Entity Type:Individual
Prefix:MRS
First Name:TABITHA
Middle Name:DAWN
Last Name:BARRON
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 1:907 AINSWORTH DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-1607
Mailing Address - Country:US
Mailing Address - Phone:928-777-0070
Mailing Address - Fax:928-445-7163
Practice Address - Street 1:907 AINSWORTH DR
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-1607
Practice Address - Country:US
Practice Address - Phone:928-777-0070
Practice Address - Fax:928-445-7163
Is Sole Proprietor?:No
Enumeration Date:2012-05-01
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP4372363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health