Provider Demographics
NPI:1689639965
Name:BARTON, PEGGY L (APNP)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:L
Last Name:BARTON
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:MINERAL POINT
Mailing Address - State:WI
Mailing Address - Zip Code:53565-1202
Mailing Address - Country:US
Mailing Address - Phone:608-987-2391
Mailing Address - Fax:608-987-4366
Practice Address - Street 1:227 COMMERCE ST
Practice Address - Street 2:
Practice Address - City:MINERAL POINT
Practice Address - State:WI
Practice Address - Zip Code:53565-1202
Practice Address - Country:US
Practice Address - Phone:608-987-2391
Practice Address - Fax:608-987-4366
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI603363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1022194OtherPHYSICIANS PLUS
WI43839800Medicaid
WI4753OtherDEAN HEALTH INSURANCE
WI500021738Medicare PIN
S27121Medicare UPIN
WI009357155Medicare PIN