Provider Demographics
NPI:1336192343
Name:BARNES, SUSAN J (APRN)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:J
Last Name:BARNES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 MCGREGOR ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-3750
Mailing Address - Country:US
Mailing Address - Phone:603-663-6200
Mailing Address - Fax:603-663-6257
Practice Address - Street 1:88 MCGREGOR ST
Practice Address - Street 2:SUITE 105
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-3750
Practice Address - Country:US
Practice Address - Phone:603-663-6200
Practice Address - Fax:603-663-6257
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH03577321163WP0808X
NH0357732308363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
P02611Medicare UPIN
NP2299Medicare ID - Type Unspecified