Provider Demographics
NPI:1720069289
Name:LEARY, BARBARA FRANCES (FNP, PA)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:FRANCES
Last Name:LEARY
Suffix:
Gender:F
Credentials:FNP, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:128 YANKTON ST
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-8142
Mailing Address - Country:US
Mailing Address - Phone:916-985-7948
Mailing Address - Fax:916-985-2724
Practice Address - Street 1:128 YANKTON ST
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-8142
Practice Address - Country:US
Practice Address - Phone:916-985-7948
Practice Address - Fax:916-985-2724
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-10
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP237735363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS35442Medicare UPIN