Basic Information
| Provider Information | |||||||||
| NPI: | 1215908405 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OTTO | ||||||||
| FirstName: | BARBARA | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | NP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SCHEARER | ||||||||
| OtherFirstName: | BARBARA | ||||||||
| OtherMiddleName: | M | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | CRNP | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 495 THOMAS JONES WAY | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | EXTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193412553 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6105608550 | ||||||||
| FaxNumber: | 6102801569 | ||||||||
| Practice Location | |||||||||
| Address1: | 495 THOMAS JONES WAY | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | EXTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193412553 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6105608550 | ||||||||
| FaxNumber: | 6102801569 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/27/2006 | ||||||||
| LastUpdateDate: | 03/10/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LX0001X | SP007907 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 1783498 | 01 | PA | BCBS | OTHER | 30027682 | 01 | PA | KEYSTONE MERCY | OTHER | 5939631 | 01 | PA | CIGNA | OTHER | 10154674801 | 01 | PA | AMERICHOICE | OTHER | 1015467480001 | 05 | PA | MEDICAID |