Basic Information
Provider Information
NPI: 1821178591
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAMPSON
FirstName: BARBARA
MiddleName: JB
NamePrefix: MS.
NameSuffix:  
Credential: NURSE PRACTITIONER
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2817 REILLY ROAD MCXC-COD CREDENTIALS
Address2: WOMACK ARMY MEDICAL CENTER
City: FORT BRAGG
State: NC
PostalCode: 283100001
CountryCode: US
TelephoneNumber: 9109078922
FaxNumber: 9109076069
Practice Location
Address1: 2817 REILLY ROAD MCXC-COD CREDENTIALS
Address2: WOMACK ARMY MEDICAL CENTER
City: FORT BRAGG
State: NC
PostalCode: 283100001
CountryCode: US
TelephoneNumber: 9109078922
FaxNumber: 9109076069
Other Information
ProviderEnumerationDate: 10/17/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LW0102X800136NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health

No ID Information.


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