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General NPI Number Information
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NPI Number | 1588711246
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Entity Type | Individual
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Provider Name | BARBARA TICKTON CRNP
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Gender | Female
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 02/06/2014
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Provider Practice Location Address
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Address Line | 128 E. MILLTOWN ROAD SUITE 105
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City | WOOSTER
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State | OH
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Zip | 44691
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Country | US
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Telephone | 330-345-8060
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Fax |
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Provider Business Mailing Address
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Address Line | 128 E MILLTOWN RD SUITE 105
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City | WOOSTER
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State | OH
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Zip | 44691-6109
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Country | US
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Telephone | 330-345-8060
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN248334
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License Number State | OH
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