MEDICARE: MRS. BARBARA GAIL MAXWELL ACNP

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	363LA2100X	Acute Care Nurse Practitioner	239953	TX

General Provider Information

NPI Number	:	1619056496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BARBARA GAIL MAXWELL ACNP

Provider Business Mailing Address
First Line	:	272 QUAIL CREEK CIR
Second Line	:
City	:	POTTSBORO
State	:	TX
Zip	:	75076-3441
Country	:	US
Telephone Number	:	903-786-9754
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 N HIGHLAND
Second Line	:	# 130
City	:	SHERMAN
State	:	TX
Zip	:	75092-7383
Country	:	US
Telephone Number	:	903-892-9179
Fax Number	:	903-868-2317

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

Provider Enumeration Date	:	11/03/2006
Last Update Date	:	11/01/2007

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