Healthcare Provider Details

I. General information

NPI: 1689984528
Provider Name (Legal Business Name): AMY C. BARTON N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2010
Last Update Date: 06/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 S MAIN ST SUITE 2
DAYTON OH
45409-2698
US

IV. Provider business mailing address

1520 S MAIN ST SUITE 2
DAYTON OH
45409-2698
US

V. Phone/Fax

Practice location:
  • Phone: 937-461-5815
  • Fax: 937-461-2896
Mailing address:
  • Phone: 937-461-5815
  • Fax: 937-461-2896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN.314497
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberCOA.12030-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: