Provider Demographics
NPI:1487054318
Name:OBERLIN, BARBARA (RN, BSN, PHN)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:OBERLIN
Suffix:
Gender:F
Credentials:RN, BSN, PHN
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:
Other - Last Name:TRAVER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:1805 FORD AVE N
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GLENCOE
Mailing Address - State:MN
Mailing Address - Zip Code:55336-1363
Mailing Address - Country:US
Mailing Address - Phone:320-864-1736
Mailing Address - Fax:
Practice Address - Street 1:1805 FORD AVE N
Practice Address - Street 2:SUITE 200
Practice Address - City:GLENCOE
Practice Address - State:MN
Practice Address - Zip Code:55336-1363
Practice Address - Country:US
Practice Address - Phone:320-864-1736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-28
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR109444-2163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health