Provider Demographics
NPI:1578840575
Name:STONE, BARBARA (MSN, IBCLC)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:MSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 TOWER DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79761-4238
Mailing Address - Country:US
Mailing Address - Phone:432-352-6099
Mailing Address - Fax:
Practice Address - Street 1:850 TOWER DR
Practice Address - Street 2:SUITE 105
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-4238
Practice Address - Country:US
Practice Address - Phone:432-352-6099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX605152163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant