Healthcare Provider Details

I. General information

NPI: 1336517713
Provider Name (Legal Business Name): BARBARA REPIC RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2015
Last Update Date: 09/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

659 3RD ST
BEAVER PA
15009-2115
US

IV. Provider business mailing address

659 3RD ST
BEAVER PA
15009-2115
US

V. Phone/Fax

Practice location:
  • Phone: 724-775-1118
  • Fax: 724-775-2375
Mailing address:
  • Phone: 724-775-1118
  • Fax: 724-775-2375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number351494
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: