Provider Demographics
NPI:1902127590
Name:MCNAMARA, BARBARA B (CRNP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:B
Last Name:MCNAMARA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:498 S MAIN ST
Mailing Address - Street 2:STE D
Mailing Address - City:MONTROSE
Mailing Address - State:PA
Mailing Address - Zip Code:18801-1317
Mailing Address - Country:US
Mailing Address - Phone:570-888-5858
Mailing Address - Fax:
Practice Address - Street 1:1246 STATE ROUTE 38
Practice Address - Street 2:
Practice Address - City:OWEGO
Practice Address - State:NY
Practice Address - Zip Code:13827-3217
Practice Address - Country:US
Practice Address - Phone:607-687-6101
Practice Address - Fax:607-798-1452
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010733363LF0000X
NYF336270363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03467874Medicaid
NY03467874Medicaid