Provider Demographics
NPI:1750704383
Name:VAN WETERING, BARBARA (RN)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:VAN WETERING
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 TALSMAN DR
Mailing Address - Street 2:UNIT #4
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-1243
Mailing Address - Country:US
Mailing Address - Phone:330-230-6099
Mailing Address - Fax:
Practice Address - Street 1:210 TALSMAN DR
Practice Address - Street 2:UNIT #4
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-1243
Practice Address - Country:US
Practice Address - Phone:330-230-6099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-03
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN323355163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse