Provider Demographics
NPI:1942336680
Name:DEETS-MATHEWS, BARBARA J (PNP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:J
Last Name:DEETS-MATHEWS
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:J
Other - Last Name:MATHEWS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PNP
Mailing Address - Street 1:940 CARY PARKWAY SE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-7417
Mailing Address - Country:US
Mailing Address - Phone:919-858-4925
Mailing Address - Fax:919-859-6595
Practice Address - Street 1:940 SE CARY PARKWAY
Practice Address - Street 2:SUITE 200
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7417
Practice Address - Country:US
Practice Address - Phone:919-858-4925
Practice Address - Fax:919-859-6595
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC28089363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics