Provider Demographics
NPI:1114071768
Name:BARNES, MARTHA ABIGAIL (FNP)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:ABIGAIL
Last Name:BARNES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5324 LEESA DR
Mailing Address - Street 2:
Mailing Address - City:CLEMMONS
Mailing Address - State:NC
Mailing Address - Zip Code:27012-9446
Mailing Address - Country:US
Mailing Address - Phone:336-710-7199
Mailing Address - Fax:
Practice Address - Street 1:1834 WAKEFOREST RD
Practice Address - Street 2:WAKE FOREST UNIVERSITY STUDENT HEALTH SERVICES
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106
Practice Address - Country:US
Practice Address - Phone:336-758-5218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201076363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily