Provider Demographics
NPI:1508067034
Name:ANDERSON, BARBARA JO (RN)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:JO
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:JO
Other - Last Name:HELM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4053 WALNUT CROSSING DRIVE
Mailing Address - Street 2:
Mailing Address - City:GROVEPORT
Mailing Address - State:OH
Mailing Address - Zip Code:43125
Mailing Address - Country:US
Mailing Address - Phone:614-833-1338
Mailing Address - Fax:
Practice Address - Street 1:4053 WALNUT CROSSING DRIVE
Practice Address - Street 2:
Practice Address - City:GROVEPORT
Practice Address - State:OH
Practice Address - Zip Code:43125
Practice Address - Country:US
Practice Address - Phone:614-833-1338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN257262163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2241041Medicaid