Healthcare Provider Details

I. General information

NPI: 1457885774
Provider Name (Legal Business Name): PORTIA DESIREE BARTON RN, IBCLC, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2017
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 N MAIN ST SECOND FLOOR, 267
PROVIDENCE RI
02904-5762
US

IV. Provider business mailing address

901 MAIN ST
EAST GREENWICH RI
02818-3116
US

V. Phone/Fax

Practice location:
  • Phone: 401-228-6579
  • Fax:
Mailing address:
  • Phone: 401-487-8619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberLLC00096
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN57151
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: