Provider Demographics
NPI:1063986024
Name:BARRIENTOS, ROSALINDA (NP)
Entity type:Individual
Prefix:
First Name:ROSALINDA
Middle Name:
Last Name:BARRIENTOS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 ARSENAL ST APT 414
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-3087
Mailing Address - Country:US
Mailing Address - Phone:210-250-1913
Mailing Address - Fax:
Practice Address - Street 1:90 WELLS AVE
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02459-3210
Practice Address - Country:US
Practice Address - Phone:617-969-6130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-13
Last Update Date:2019-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2293636363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care