Provider Demographics
NPI:1619318565
Name:SUTTON, BARBARA LYNN (LPN)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:LYNN
Last Name:SUTTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2711 COUNTY ROAD 63
Mailing Address - Street 2:
Mailing Address - City:TUSKEGEE
Mailing Address - State:AL
Mailing Address - Zip Code:36083-4203
Mailing Address - Country:US
Mailing Address - Phone:334-707-6645
Mailing Address - Fax:
Practice Address - Street 1:2711 COUNTY ROAD 63
Practice Address - Street 2:
Practice Address - City:TUSKEGEE
Practice Address - State:AL
Practice Address - Zip Code:36083-4203
Practice Address - Country:US
Practice Address - Phone:334-707-6645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-08
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN044389164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse