Provider Demographics
NPI:1346494077
Name:LEVINE, BARBARA (CRNP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:LEVINE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 MASSACHUSETTS AVE
Mailing Address - Street 2:APT 1002
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-3505
Mailing Address - Country:US
Mailing Address - Phone:610-574-7112
Mailing Address - Fax:
Practice Address - Street 1:255 MASSACHUSETTS AVE
Practice Address - Street 2:APT 1002
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-3505
Practice Address - Country:US
Practice Address - Phone:610-574-7112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-07
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RINPP37657363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner