Provider Demographics
NPI:1598918674
Name:VANNORTWICK, BARBARA LYNN
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:LYNN
Last Name:VANNORTWICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 SLEEPY HOLLOW ESTATES
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18302
Mailing Address - Country:US
Mailing Address - Phone:570-223-7932
Mailing Address - Fax:
Practice Address - Street 1:303 SLEEPY HOLLOW ESTATES
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18302
Practice Address - Country:US
Practice Address - Phone:570-223-7932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00063500174400000X
PAOC004372L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist