Healthcare Provider Details

I. General information

NPI: 1316636426
Provider Name (Legal Business Name): NICHOLAS BARTON RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2023
Last Update Date: 05/04/2023
Certification Date: 05/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4110 US HIGHWAY 31 S
DECATUR AL
35603-1644
US

IV. Provider business mailing address

1316 SOMERVILLE RD SE STE 1
DECATUR AL
35601-4309
US

V. Phone/Fax

Practice location:
  • Phone: 256-260-7360
  • Fax: 256-355-6092
Mailing address:
  • Phone: 256-260-7361
  • Fax: 256-355-6092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-144649
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: