MEDICARE: BARBARA B. MAXWELL A.P.R.N.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LS0200X	School Nurse Practitioner	AP01767	LA
2	363LA2200X	Adult Health Nurse Practitioner	AP01767	LA
3	363LF0000X	Family Nurse Practitioner	AP01767	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568478550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA B. MAXWELL A.P.R.N.

Provider Business Mailing Address
First Line	:	234 MARLIN DR
Second Line	:
City	:	SLIDELL
State	:	LA
Zip	:	70461-1116
Country	:	US
Telephone Number	:	985-645-9066
Fax Number	:	985-730-7183

Provider Business Practice Location Address
First Line	:	1545 TULANE AVE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70112-2821
Country	:	US
Telephone Number	:	504-903-5155
Fax Number	:	504-903-5157

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	02/15/2008

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