Healthcare Provider Details

I. General information

NPI: 1285448977
Provider Name (Legal Business Name): JENNIFER ANN BARR BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2025
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

367 PINE ST
SPRINGFIELD MA
01105-1930
US

IV. Provider business mailing address

164 LANCASTER AVE
WEST SPRINGFIELD MA
01089-2224
US

V. Phone/Fax

Practice location:
  • Phone: 413-867-1945
  • Fax:
Mailing address:
  • Phone: 413-388-3993
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number105947
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: