Provider Demographics
NPI:1538257704
Name:LORDAN, BARBARA A (NP)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:A
Last Name:LORDAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:BARBARA
Other - Middle Name:A
Other - Last Name:GATELY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:8 SCHOONER WAY
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02050-6810
Mailing Address - Country:US
Mailing Address - Phone:781-834-1517
Mailing Address - Fax:
Practice Address - Street 1:700 CONGRESS ST
Practice Address - Street 2:SUITE 301
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-0909
Practice Address - Country:US
Practice Address - Phone:617-786-1460
Practice Address - Fax:617-786-1463
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA106071363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0339270Medicaid
MA0339270Medicaid