Provider Demographics
NPI:1083193338
Name:BARNHART, SUZANNA DAVIS (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNA
Middle Name:DAVIS
Last Name:BARNHART
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:SUZANNA
Other - Middle Name:LINDSAY
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6077 PRIMACY PKWY STE 140
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-5754
Mailing Address - Country:US
Mailing Address - Phone:901-259-1600
Mailing Address - Fax:901-259-1600
Practice Address - Street 1:6286 BRIARCREST AVE STE 200
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-4023
Practice Address - Country:US
Practice Address - Phone:901-259-1600
Practice Address - Fax:901-259-1698
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN195485163W00000X
MS904499363LF0000X
TN27487363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ063781Medicaid
MS1N1113OtherMS MEDICARE
TNT18025AOtherTN MEDICARE
TN6261386OtherBCBS TN