Healthcare Provider Details
I. General information
NPI: 1801870167
Provider Name (Legal Business Name): JUANITA STOLTZFUS BARTER BSN RNC
Entity Type: Individual
Gender: Female
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 12/01/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1651 MOUNT ZION RD
YORK PA
17402-9086
US
IV. Provider business mailing address
373 HOLLY HOCK CIR
MOUNTVILLE PA
17554-1252
US
V. Phone/Fax
- Phone: 717-600-0900
- Fax: 717-600-0910
- Phone: 717-285-0414
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WP0807X |
| Taxonomy | Child & Adolescent Psychiatric/Mental Health Registered Nurse |
| License Number | RN276296L |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WP0807X |
| Taxonomy | Child & Adolescent Psychiatric/Mental Health Registered Nurse |
| License Number | 532735 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: