Provider Demographics
NPI:1043291891
Name:BARRETT, DIANA C (EMT-B)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:C
Last Name:BARRETT
Suffix:
Gender:F
Credentials:EMT-B
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 JACLYN DR
Mailing Address - Street 2:
Mailing Address - City:SAYLORSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18353-9669
Mailing Address - Country:US
Mailing Address - Phone:570-504-1671
Mailing Address - Fax:
Practice Address - Street 1:13 JACLYN DR
Practice Address - Street 2:
Practice Address - City:SAYLORSBURG
Practice Address - State:PA
Practice Address - Zip Code:18353-9669
Practice Address - Country:US
Practice Address - Phone:570-504-1671
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA177386146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic