Provider Demographics
NPI:1003629924
Name:WHITE-BARB, ANNALEW BLIZZARD (BA, RN, LCCE)
Entity type:Individual
Prefix:
First Name:ANNALEW
Middle Name:BLIZZARD
Last Name:WHITE-BARB
Suffix:
Gender:F
Credentials:BA, RN, LCCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:459 DICK SPENCER RD
Mailing Address - Street 2:
Mailing Address - City:FRANKFORD
Mailing Address - State:WV
Mailing Address - Zip Code:24938-7061
Mailing Address - Country:US
Mailing Address - Phone:304-771-8933
Mailing Address - Fax:
Practice Address - Street 1:459 DICK SPENCER RD
Practice Address - Street 2:
Practice Address - City:FRANKFORD
Practice Address - State:WV
Practice Address - Zip Code:24938-7061
Practice Address - Country:US
Practice Address - Phone:304-771-8933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV105373163WC1500X, 174H00000X, 163W00000X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No174H00000XOther Service ProvidersHealth Educator
No374J00000XNursing Service Related ProvidersDoula