Provider Demographics
NPI:1962486407
Name:LORD, BARBRA COLLINS (RN, MSN, CNS, NP)
Entity Type:Individual
Prefix:
First Name:BARBRA
Middle Name:COLLINS
Last Name:LORD
Suffix:
Gender:F
Credentials:RN, MSN, CNS, NP
Other - Prefix:
Other - First Name:BARBRA
Other - Middle Name:LOUISE
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4621 CREEK RD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95841-4126
Mailing Address - Country:US
Mailing Address - Phone:916-483-6506
Mailing Address - Fax:
Practice Address - Street 1:2315 STOCKTON BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2201
Practice Address - Country:US
Practice Address - Phone:916-734-2118
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16148363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner