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NPI Code Detail

MEDICARE: BARBARA COMER RN

MEDICARE: BARBARA COMER RN
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
1163W00000XRegistered Nurse28148763AIN

General Provider Information

NPI Number : 1689894693
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARBARA COMER RN
Provider Business Mailing Address
First Line : 9835 RED TWIG PL
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-5989
Country : US
Telephone Number : 260-338-1241
Fax Number :
Provider Business Practice Location Address
First Line : 808 MILL LAKE RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-6400
Country : US
Telephone Number : 260-338-1241
Fax Number : 260-338-1231
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2007
Last Update Date : 07/09/2007

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