Provider Demographics
NPI:1477744787
Name:BARBER, MARYGRACE DAVIE (NP)
Entity Type:Individual
Prefix:MS
First Name:MARYGRACE
Middle Name:DAVIE
Last Name:BARBER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 FAIRGREEN PL
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-2721
Mailing Address - Country:US
Mailing Address - Phone:617-566-9627
Mailing Address - Fax:
Practice Address - Street 1:BENTLEY COLLEGE
Practice Address - Street 2:175 FOREST ST
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02452-4705
Practice Address - Country:US
Practice Address - Phone:781-891-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA127037363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health