Provider Demographics
NPI:1699472217
Name:BARLETTA, EIMILE ANN (AGNP-C)
Entity type:Individual
Prefix:
First Name:EIMILE
Middle Name:ANN
Last Name:BARLETTA
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:EIMILE
Other - Middle Name:ANN
Other - Last Name:MAXWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:331R HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-1738
Mailing Address - Country:US
Mailing Address - Phone:978-745-1200
Mailing Address - Fax:
Practice Address - Street 1:331R HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-1738
Practice Address - Country:US
Practice Address - Phone:978-745-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-14
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAAG01230091363LP2300X
MARN2333782363LP2300X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care