Provider Demographics
NPI:1639215098
Name:BARTON, MEREDITH R
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:R
Last Name:BARTON
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 1:119 GLECKLER RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-3487
Mailing Address - Country:US
Mailing Address - Phone:207-774-7257
Mailing Address - Fax:
Practice Address - Street 1:119 GLECKLER RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-3487
Practice Address - Country:US
Practice Address - Phone:207-774-7257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME3002385373H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist