Provider Demographics
NPI:1790783579
Name:ZVODAR, BARBARA ITHA (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:ITHA
Last Name:ZVODAR
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 DIANE MCCAIN RD
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:NH
Mailing Address - Zip Code:03833-6125
Mailing Address - Country:US
Mailing Address - Phone:603-642-7416
Mailing Address - Fax:
Practice Address - Street 1:VETERANS ADMINISTRATION MEDICAL CENTER
Practice Address - Street 2:718 SMYTH ROAD
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104
Practice Address - Country:US
Practice Address - Phone:603-624-4366
Practice Address - Fax:603-629-3253
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH32616367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3074473Medicaid