Healthcare Provider Details

I. General information

NPI: 1760824247
Provider Name (Legal Business Name): ANA MARIA BARBOSA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2013
Last Update Date: 07/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 CHESTNUT LN
BROCKTON MA
02301-6378
US

IV. Provider business mailing address

22 CHESTNUT LN
BROCKTON MA
02301-6378
US

V. Phone/Fax

Practice location:
  • Phone: 407-361-3265
  • Fax:
Mailing address:
  • Phone: 407-361-3265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number228519
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: