Provider Demographics
NPI:1215684725
Name:BARB, VIRGINIA JEAN (RN)
Entity type:Individual
Prefix:MISS
First Name:VIRGINIA
Middle Name:JEAN
Last Name:BARB
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16322 W RIVERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-6798
Mailing Address - Country:US
Mailing Address - Phone:208-691-1138
Mailing Address - Fax:
Practice Address - Street 1:16322 W RIVERVIEW DR
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-6798
Practice Address - Country:US
Practice Address - Phone:208-691-1138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-04
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID45621163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine