Healthcare Provider Details

I. General information

NPI: 1851481931
Provider Name (Legal Business Name): MRS. BARBARA MARIE JARBOE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 WEST AVE LOWER LEVEL
NORWALK CT
06850-4034
US

IV. Provider business mailing address

11 PIONEER TRL
TRUMBULL CT
06611-1220
US

V. Phone/Fax

Practice location:
  • Phone: 203-852-2417
  • Fax:
Mailing address:
  • Phone: 203-261-1499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number003152
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: