Provider Demographics
NPI:1851491336
Name:TYNAN, BARBARA JEANNE (ANP)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:JEANNE
Last Name:TYNAN
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 QUINCY SHORE DR
Mailing Address - Street 2:#75
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02171-2917
Mailing Address - Country:US
Mailing Address - Phone:617-847-6397
Mailing Address - Fax:
Practice Address - Street 1:162 QUINCY SHORE DR
Practice Address - Street 2:#75
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02171-2917
Practice Address - Country:US
Practice Address - Phone:617-847-6397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA173387282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital