Provider Demographics
NPI:1518082288
Name:WORTMAN, BARBARA A (RNFA)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:WORTMAN
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 241769
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99524-1769
Mailing Address - Country:US
Mailing Address - Phone:907-770-2301
Mailing Address - Fax:907-770-2325
Practice Address - Street 1:21134 LOWLAND AVE
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-9584
Practice Address - Country:US
Practice Address - Phone:907-696-7670
Practice Address - Fax:907-550-6179
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK16761163WR0006X, 364SM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
No364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-Surgical