Provider Demographics
NPI:1518985225
Name:HUMRICK, BARBARA A (CNP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:HUMRICK
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24701 EUCLID AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1821-NP363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000370807OtherANTHEM
OH000000526066OtherANTHEM
OH2497169Medicaid
OH363653OtherWELLCARE
OH2931742Medicaid
OH745919OtherBUCKEYE
OH000000221170OtherUNISON
OH7899683OtherAETNA
OH363653OtherWELLCARE
OH7899683OtherAETNA
OH000000221170OtherUNISON
OH2931742Medicaid