MEDICARE: MRS. BARBARANN LAYTON FNP

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	363LF0000X	Family Nurse Practitioner	SP012631	PA

General Provider Information

NPI Number	:	1619214491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BARBARANN LAYTON FNP

Provider Business Mailing Address
First Line	:	4517 E THOMPSON ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19137-2003
Country	:	US
Telephone Number	:	215-535-1275
Fax Number	:

Provider Business Practice Location Address
First Line	:	4517 E THOMPSON ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19137-2003
Country	:	US
Telephone Number	:	215-535-1275
Fax Number	:

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

Provider Enumeration Date	:	01/14/2013
Last Update Date	:	05/05/2017

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