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NPI Code Detail

MEDICARE: MRS. BARBARA A WOS ELLEDGE ARNP FNP

MEDICARE: MRS. BARBARA A WOS ELLEDGE ARNP 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
1363LF0000XFamily Nurse PractitionerAP30000123WA
2363LF0000XFamily Nurse PractitionerRN00065779WA

General Provider Information

NPI Number : 1730177841
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BARBARA A WOS ELLEDGE ARNP FNP
Provider Business Mailing Address
First Line : 104 W 5TH AVE
Second Line :
City : SPOKANE
State : WA
Zip : 99204-4880
Country : US
Telephone Number : 509-474-2072
Fax Number : 509-474-6606
Provider Business Practice Location Address
First Line : 1200 E COLUMBIA AVE
Second Line :
City : COLVILLE
State : WA
Zip : 99114-3354
Country : US
Telephone Number : 509-684-3701
Fax Number : 509-684-5817
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2005
Last Update Date : 03/14/2014

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