Healthcare Provider Details

I. General information

NPI: 1740410547
Provider Name (Legal Business Name): BARBARA ANN CLINE LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BARBARA ANN CLINE LPN

II. Dates (important events)

Enumeration Date: 07/15/2009
Last Update Date: 09/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

481 CANISTEO ST
HORNELL NY
14843-9768
US

IV. Provider business mailing address

4225 BACK RIVER RD
SCIO NY
14880-9614
US

V. Phone/Fax

Practice location:
  • Phone: 585-593-3760
  • Fax:
Mailing address:
  • Phone: 585-808-6240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number314900
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number019997
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: