Provider Demographics
NPI:1467421719
Name:STAGG, BARBARA L (CFNP)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:L
Last Name:STAGG
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 S PENN AVE
Mailing Address - Street 2:
Mailing Address - City:HARRISVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26362-1371
Mailing Address - Country:US
Mailing Address - Phone:304-643-4005
Mailing Address - Fax:304-643-4007
Practice Address - Street 1:135 S PENN AVE
Practice Address - Street 2:
Practice Address - City:HARRISVILLE
Practice Address - State:WV
Practice Address - Zip Code:26362-1371
Practice Address - Country:US
Practice Address - Phone:304-643-4005
Practice Address - Fax:304-643-4007
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV25183363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810001005Medicaid
Q34148Medicare UPIN
STNP17251Medicare PIN