Provider Demographics
NPI:1033298856
Name:BARNES, CARRIE (CRNP)
Entity Type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:
Last Name:BARNES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2213
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:AL
Mailing Address - Zip Code:36702-2213
Mailing Address - Country:US
Mailing Address - Phone:334-963-4201
Mailing Address - Fax:
Practice Address - Street 1:7079 HIGHWAY 10 W
Practice Address - Street 2:
Practice Address - City:PINE HILL
Practice Address - State:AL
Practice Address - Zip Code:36769-3326
Practice Address - Country:US
Practice Address - Phone:334-963-4201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1029674363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL630804012Medicaid
630737968OtherTIN