Provider Demographics
NPI:1215974852
Name:MACDONALD, BARBARA A (CNP)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:A
Last Name:MACDONALD
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
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Mailing Address - Street 1:8632 ONALASKA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-2833
Mailing Address - Country:US
Mailing Address - Phone:858-277-5728
Mailing Address - Fax:858-505-4661
Practice Address - Street 1:4060 4TH AVE
Practice Address - Street 2:SUITE 508
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2116
Practice Address - Country:US
Practice Address - Phone:619-467-6188
Practice Address - Fax:619-293-0122
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2009-04-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA236970363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC236970OtherLICENSE