Provider Demographics
NPI:1952442220
Name:BARRY, REBECCA JEAN (NP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:JEAN
Last Name:BARRY
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 1:79 PINECREST ROAD
Mailing Address - Street 2:
Mailing Address - City:WEST BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02379-1341
Mailing Address - Country:US
Mailing Address - Phone:508-587-2732
Mailing Address - Fax:
Practice Address - Street 1:175 GEORGE WASHINGTON BLVD
Practice Address - Street 2:HULL TEEN & WOMENS HEALTH
Practice Address - City:HULL
Practice Address - State:MA
Practice Address - Zip Code:02045-3001
Practice Address - Country:US
Practice Address - Phone:781-925-0671
Practice Address - Fax:781-925-8986
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN NP 191245363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MB0613857IOtherDPH MA