Provider Demographics
NPI:1982831251
Name:HATHAWAY, BARBARA KINGSLEY (RNC, ANP,MIH)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:KINGSLEY
Last Name:HATHAWAY
Suffix:
Gender:F
Credentials:RNC, ANP,MIH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01910-0001
Mailing Address - Country:US
Mailing Address - Phone:791-594-3817
Mailing Address - Fax:
Practice Address - Street 1:1000 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01910-0001
Practice Address - Country:US
Practice Address - Phone:781-594-3817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-15
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA98291363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health