Provider Demographics
NPI:1598135790
Name:WALSH, BARBARA A (NP-C)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:WALSH
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:A
Other - Last Name:HAWKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:1011 BOARDMAN CANFIELD RD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-4226
Mailing Address - Country:US
Mailing Address - Phone:330-629-2888
Mailing Address - Fax:330-629-2946
Practice Address - Street 1:1011 BOARDMAN CANFIELD RD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-4226
Practice Address - Country:US
Practice Address - Phone:330-629-2888
Practice Address - Fax:330-629-2946
Is Sole Proprietor?:No
Enumeration Date:2015-09-30
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH18196363LG0600X, 363LP2300X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0149032Medicaid
OH0149032Medicaid