Provider Demographics
NPI:1912089517
Name:ALBERT, BARBARA A (PAC)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:ALBERT
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2238 TODDS LN
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-3159
Mailing Address - Country:US
Mailing Address - Phone:757-315-8100
Mailing Address - Fax:414-622-3886
Practice Address - Street 1:2238 TODDS LN
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-3159
Practice Address - Country:US
Practice Address - Phone:757-315-8100
Practice Address - Fax:414-622-3886
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA110840788363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAQ79347Medicare UPIN
VA013575F36Medicare Oscar/Certification