Barbara Jean Balcius-Sullivan, CLPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LN56419 Issued in MA

Practice address

177 Carroll Ave
Brockton, MA 02301-6315

Phone

(508) 510-5133

Fax

(508) 583-9800

NPI assigned

Apr 5, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522886400000",
    "number": "1508362682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 PLYMOUTH ST",
            "city": "MIDDLEBORO",
            "state": "MA",
            "postal_code": "023461106",
            "telephone_number": "508-510-5133",
            "fax_number": "580-583-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 CARROLL AVE",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023016315",
            "telephone_number": "508-510-5133",
            "fax_number": "508-583-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALCIUS-SULLIVAN",
        "first_name": "BARBARA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "CLPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-05",
        "last_updated": "2018-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MA",
            "license": "LN56419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Licensed Practical Nurse in Brockton, MA
• Providers in Brockton, MA by specialty
• Licensed Practical Nurse in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.