Provider Demographics
NPI:1942618731
Name:MAUPIN, BARRY (ACNP-BC, FNP-C)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:
Last Name:MAUPIN
Suffix:
Gender:M
Credentials:ACNP-BC, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7294
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-0639
Mailing Address - Country:US
Mailing Address - Phone:623-760-7660
Mailing Address - Fax:567-243-7800
Practice Address - Street 1:18158 W DESERT SAGE DR
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-7846
Practice Address - Country:US
Practice Address - Phone:623-760-7660
Practice Address - Fax:567-243-7800
Is Sole Proprietor?:No
Enumeration Date:2014-07-24
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP5737363LF0000X, 363LP2300X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care