MEDICARE: BARBARA ELDREDGE, RN, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse

General Provider Information

NPI Number	:	1629503321
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARBARA ELDREDGE, RN, PLLC

Provider Business Mailing Address
First Line	:	700 NW CROSBY AVE TRLR 180
Second Line	:
City	:	OAK HARBOR
State	:	WA
Zip	:	98277-3871
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 NW CROSBY AVE TRLR 180
Second Line	:
City	:	OAK HARBOR
State	:	WA
Zip	:	98277-3871
Country	:	US
Telephone Number	:	360-675-7800
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BARBARA ELDREDGE
Credential	:	RN
Telephone Number	:	360-675-7800

Provider Enumeration Date	:	05/01/2017
Last Update Date	:	05/01/2017

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