Provider Demographics
NPI:1457638074
Name:BARB, SUSAN (CRNP)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:BARB
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:HANDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1401 CHESTER PIKE
Mailing Address - Street 2:SUITE B
Mailing Address - City:EDDYSTONE
Mailing Address - State:PA
Mailing Address - Zip Code:19022-1336
Mailing Address - Country:US
Mailing Address - Phone:610-447-0609
Mailing Address - Fax:610-649-4421
Practice Address - Street 1:1401 CHESTER PIKE
Practice Address - Street 2:SUITE B
Practice Address - City:EDDYSTONE
Practice Address - State:PA
Practice Address - Zip Code:19022-1336
Practice Address - Country:US
Practice Address - Phone:610-447-0609
Practice Address - Fax:610-649-4421
Is Sole Proprietor?:No
Enumeration Date:2011-11-10
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP011731363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103010166-0001Medicaid
PA103010166-0001Medicaid