Provider Demographics
NPI:1164479028
Name:MACDONALD, BARBARA (ARNP)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:MACDONALD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 UNIVERSAL DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-4787
Mailing Address - Country:US
Mailing Address - Phone:850-385-1839
Mailing Address - Fax:850-386-8371
Practice Address - Street 1:616 UNIVERSAL DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-4787
Practice Address - Country:US
Practice Address - Phone:850-385-1839
Practice Address - Fax:850-386-8371
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2718602363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC05233OtherUNIVERSAL HEALTH CARE
FLP30502Medicare UPIN
FLY4454ZMedicare ID - Type UnspecifiedMEDICARE
DC05233OtherUNIVERSAL HEALTH CARE