Provider Demographics
NPI:1598192189
Name:WAMSLEY, BARBARA JEAN (RPH)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:JEAN
Last Name:WAMSLEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6196 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:INDIAN RIVER
Mailing Address - State:MI
Mailing Address - Zip Code:49749-9725
Mailing Address - Country:US
Mailing Address - Phone:231-238-9458
Mailing Address - Fax:
Practice Address - Street 1:1401 SPRING ST
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2884
Practice Address - Country:US
Practice Address - Phone:231-347-7281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302027404183500000X
OH03317209183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH03317209OtherPHARMACIST LICENSE
MI5302027404OtherPHARMACIST LICENSE