Basic Information
| Provider Information | |||||||||
| NPI: | 1336192343 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARNES | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 88 MCGREGOR ST | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | MANCHESTER | ||||||||
| State: | NH | ||||||||
| PostalCode: | 031023750 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6036636200 | ||||||||
| FaxNumber: | 6036636257 | ||||||||
| Practice Location | |||||||||
| Address1: | 88 MCGREGOR ST | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | MANCHESTER | ||||||||
| State: | NH | ||||||||
| PostalCode: | 031023750 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6036636200 | ||||||||
| FaxNumber: | 6036636257 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2006 | ||||||||
| LastUpdateDate: | 03/11/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/11/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0808X | 03577321 | NH | N | Nursing Service Providers | Registered Nurse | Psych/Mental Health | 363LP0808X | 0357732308 | NH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.