Provider Demographics
NPI:1316544596
Name:KUCINICH, BARBARA L (APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:L
Last Name:KUCINICH
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:K
Other - Last Name:WEDDLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, FNP-BC
Mailing Address - Street 1:333 FERN ST APT 1814
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-5975
Mailing Address - Country:US
Mailing Address - Phone:216-218-3303
Mailing Address - Fax:
Practice Address - Street 1:333 FERN ST APT 1814
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-5975
Practice Address - Country:US
Practice Address - Phone:216-218-3303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-01
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11009419363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily