Provider Demographics
NPI:1336149327
Name:PATERNOSTRO, BARBARA J (FNP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:J
Last Name:PATERNOSTRO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 LAURENS RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-3224
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2210 LAURENS RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-3224
Practice Address - Country:US
Practice Address - Phone:864-288-8280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-30
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCFP4224363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149466805Medicaid
TX149466815Medicaid
TX149466802Medicaid
TX149466812Medicaid
TX149466819Medicaid
TX149466816Medicaid
TX149466824Medicaid
TX149466826Medicaid
TX149466821Medicaid
TX149466823Medicaid
TX8Y0772OtherBLUE CROSS BLUE SHIELD
TX149466806Medicaid
TX149466807Medicaid
TX149466820Medicaid
TX149466801Medicaid
TX149466817Medicaid
TX149466818Medicaid
TX149466822Medicaid
TX149466825Medicaid
TX149466828Medicaid
TX149466826Medicaid
TX87N476Medicare PIN