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General NPI Number Information
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NPI Number | 1730789744
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Entity Type | Individual
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Provider Name | POLYANA F BARBOSA FNP
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Gender | Female
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Dates
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Enumeration Date | 10/28/2020
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Last Update Date | 10/28/2020
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Provider Practice Location Address
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Address Line | 491 MAPLE ST STE 208
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City | DANVERS
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State | MA
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Zip | 01923-4025
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Country | US
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Telephone | 781-627-7070
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Fax |
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Provider Business Mailing Address
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Address Line | 135 MOUNT VERNON AVE APT 1
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City | MELROSE
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State | MA
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Zip | 02176
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Country | US
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Telephone | 339-293-2735
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN2290290
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License Number State | MA
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