Provider Demographics
NPI:1689776288
Name:WORTHINGTON, BARBARA LYNN (NP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:LYNN
Last Name:WORTHINGTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 BANK STREET
Mailing Address - Street 2:SUITE 4 BATAVIA FAMILY CARE CENTER
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020
Mailing Address - Country:US
Mailing Address - Phone:585-344-4800
Mailing Address - Fax:585-345-0461
Practice Address - Street 1:30 BANK STREET
Practice Address - Street 2:SUITE 4 BATAVIA FAMILY CARE CENTER
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020
Practice Address - Country:US
Practice Address - Phone:585-344-4800
Practice Address - Fax:585-345-0461
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF302856363LA2200X
NYF340420363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Not Answered363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0056047002OtherBCBS OF WNY
9512177OtherINDEPENDENT HEALTH
109124BFOtherPREFERRED CARE
F340420OtherNYS LICENSE GNP
241507OtherNYS LICENSE RN
7599484OtherGHI
040511000789OtherFIDELIS
F302856OtherNYS LICENSE ANP
F302856OtherNYS LICENSE ANP
MW0436192OtherDEA
S88700Medicare UPIN