Provider Demographics
NPI:1780680181
Name:VONTHRON, BARBARA A (NP)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:A
Last Name:VONTHRON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:BARBARA
Other - Middle Name:A
Other - Last Name:GOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1031 PIERCE ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-4669
Mailing Address - Country:US
Mailing Address - Phone:419-557-5541
Mailing Address - Fax:419-557-5542
Practice Address - Street 1:3960 E HARBOR LIGHT LNDG
Practice Address - Street 2:
Practice Address - City:PORT CLINTON
Practice Address - State:OH
Practice Address - Zip Code:43452-3876
Practice Address - Country:US
Practice Address - Phone:419-732-0700
Practice Address - Fax:419-732-0702
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP00894363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2505284Medicaid
OHQ24859Medicare UPIN
OH9313633Medicare ID - Type Unspecified