Provider Demographics
NPI:1023370483
Name:BARRETT, PATRICIA ANNETTE (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANNETTE
Last Name:BARRETT
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 WILLIAMS RD
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30747-6307
Mailing Address - Country:US
Mailing Address - Phone:706-506-9160
Mailing Address - Fax:
Practice Address - Street 1:6120 ALABAMA HWY
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-2804
Practice Address - Country:US
Practice Address - Phone:706-935-6442
Practice Address - Fax:706-935-6441
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN093282363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003128874EMedicaid