Provider Demographics
NPI:1740410547
Name:CLINE, BARBARA ANN (LMT)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ANN
Last Name:CLINE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:BARBARA
Other - Middle Name:ANN
Other - Last Name:CLINE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:4225 BACK RIVER RD
Mailing Address - Street 2:
Mailing Address - City:SCIO
Mailing Address - State:NY
Mailing Address - Zip Code:14880-9614
Mailing Address - Country:US
Mailing Address - Phone:585-808-6240
Mailing Address - Fax:
Practice Address - Street 1:481 CANISTEO ST
Practice Address - Street 2:
Practice Address - City:HORNELL
Practice Address - State:NY
Practice Address - Zip Code:14843-9768
Practice Address - Country:US
Practice Address - Phone:585-593-3760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-15
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019997174400000X
NY314900164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No174400000XOther Service ProvidersSpecialist