Provider Demographics
NPI:1396870275
Name:CAPEZIO, BARBARA J (CRNP RNC)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:J
Last Name:CAPEZIO
Suffix:
Gender:F
Credentials:CRNP RNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4711 SALMON ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19137-2125
Mailing Address - Country:US
Mailing Address - Phone:215-288-7325
Mailing Address - Fax:
Practice Address - Street 1:1720 S BROAD ST
Practice Address - Street 2:HEALTH CARE CENTER 2
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145-2315
Practice Address - Country:US
Practice Address - Phone:215-685-1811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP000570G363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAVP000570GOtherLICENSE