Provider Demographics
NPI:1124583232
Name:BARRETT, MISTY ANN (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:MISTY
Middle Name:ANN
Last Name:BARRETT
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 1:460 BENTMOOR WAY
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:AL
Mailing Address - Zip Code:35080-7070
Mailing Address - Country:US
Mailing Address - Phone:940-465-9303
Mailing Address - Fax:
Practice Address - Street 1:500 CAHABA PARK CIR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-5087
Practice Address - Country:US
Practice Address - Phone:205-848-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-02
Last Update Date:2019-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-135619363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics