Provider Demographics
NPI:1053342279
Name:BARRINGTON-SHULENBERGER, ROSA L (DNP, ANP, FNP)
Entity type:Individual
Prefix:DR
First Name:ROSA
Middle Name:L
Last Name:BARRINGTON-SHULENBERGER
Suffix:
Gender:F
Credentials:DNP, ANP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20170 N UMPQUA HWY
Mailing Address - Street 2:
Mailing Address - City:GLIDE
Mailing Address - State:OR
Mailing Address - Zip Code:97443-9620
Mailing Address - Country:US
Mailing Address - Phone:541-870-1363
Mailing Address - Fax:541-496-3489
Practice Address - Street 1:UMPQUA COMMUNITY HEALTH CENTER, GLIDE CLINIC
Practice Address - Street 2:20170 N UMPQUA HWY
Practice Address - City:GLIDE
Practice Address - State:OR
Practice Address - Zip Code:97443
Practice Address - Country:US
Practice Address - Phone:541-496-3504
Practice Address - Fax:541-496-3489
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR089003375N3363LA2200X
OR200450006NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR052220Medicaid
OR052220Medicaid
ORRR PTAN P00337614Medicare PIN
P55180Medicare UPIN