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NPI Code Detail

MEDICARE: BARBARA FAHEY C.R.N.P.

MEDICARE: BARBARA FAHEY C.R.N.P.
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
1363LF0000XFamily Nurse PractitionerCOANP4982OH
2363LF0000XFamily Nurse Practitioner53939WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689671703
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARBARA FAHEY C.R.N.P.
Provider Business Mailing Address
First Line : 3136 WEST ST
Second Line :
City : WEIRTON
State : WV
Zip : 26062-4637
Country : US
Telephone Number : 304-797-7733
Fax Number : 304-797-7740
Provider Business Practice Location Address
First Line : 3136 WEST ST
Second Line :
City : WEIRTON
State : WV
Zip : 26062-4637
Country : US
Telephone Number : 304-797-7733
Fax Number : 304-797-7740
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2005
Last Update Date : 01/07/2011

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