Provider Demographics
NPI:1992153514
Name:BARTH, MARIE Y
Entity type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:Y
Last Name:BARTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 E US HIGHWAY 36
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:OH
Mailing Address - Zip Code:43078-9600
Mailing Address - Country:US
Mailing Address - Phone:937-887-0164
Mailing Address - Fax:937-887-0167
Practice Address - Street 1:1880 E US HIGHWAY 36
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:OH
Practice Address - Zip Code:43078-9600
Practice Address - Country:US
Practice Address - Phone:937-887-0164
Practice Address - Fax:937-887-0167
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-25
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.19213-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily