Provider Demographics
NPI:1700945664
Name:MALONEY, BARBARA M (NP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:M
Last Name:MALONEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756-1000
Mailing Address - Country:US
Mailing Address - Phone:603-643-2854
Mailing Address - Fax:
Practice Address - Street 1:49 LYME RD
Practice Address - Street 2:C/O HANOVER TERRACE HEALTHCARE
Practice Address - City:HANOVER
Practice Address - State:NH
Practice Address - Zip Code:03755-1205
Practice Address - Country:US
Practice Address - Phone:603-643-2854
Practice Address - Fax:603-643-1723
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH030637-23-05363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30344930Medicaid
VT1013456Medicaid
Q08824Medicare UPIN
VT1013456Medicaid