Provider Demographics
NPI:1386080984
Name:BARTUS, MARILOU J (NP)
Entity type:Individual
Prefix:
First Name:MARILOU
Middle Name:J
Last Name:BARTUS
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 1:165 MILL ST FL 2
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-3289
Mailing Address - Country:US
Mailing Address - Phone:978-227-1046
Mailing Address - Fax:978-400-5608
Practice Address - Street 1:165 MILL ST FL 2
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-3289
Practice Address - Country:US
Practice Address - Phone:978-227-1046
Practice Address - Fax:978-400-5608
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-22
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN132991363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily