Healthcare Provider Details

I. General information

NPI: 1659076818
Provider Name (Legal Business Name): VIVIANA BARBOSA CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2023
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 HARRISBURG PIKE
LANCASTER PA
17601-2615
US

IV. Provider business mailing address

2826 COUNTRYSIDE DR
LANCASTER PA
17601-3506
US

V. Phone/Fax

Practice location:
  • Phone: 717-606-1155
  • Fax: 717-606-1115
Mailing address:
  • Phone: 717-635-5987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP027402
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: