Provider Demographics
NPI:1467535336
Name:MASIULIS, BARBARA A (CRNP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:MASIULIS
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 1:5396 DUNTEACHIN DR
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-8204
Mailing Address - Country:US
Mailing Address - Phone:410-747-9464
Mailing Address - Fax:
Practice Address - Street 1:1801 TURKEY POINT RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21221-1734
Practice Address - Country:US
Practice Address - Phone:410-687-5345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR132625363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics