Healthcare Provider Details

I. General information

NPI: 1093796989
Provider Name (Legal Business Name): NANCY J BARTLESON CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 08/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 PARKHURST RD
CHELMSFORD MA
01824-1510
US

IV. Provider business mailing address

85 PARKHURST RD
CHELMSFORD MA
01824-1510
US

V. Phone/Fax

Practice location:
  • Phone: 978-458-6868
  • Fax: 978-458-3735
Mailing address:
  • Phone: 978-458-6868
  • Fax: 978-458-3735

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number107611
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number107611
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: