Provider Demographics
NPI:1164780441
Name:BARFOOT, ELISSA MARIE (CNM, FNP)
Entity Type:Individual
Prefix:
First Name:ELISSA
Middle Name:MARIE
Last Name:BARFOOT
Suffix:
Gender:F
Credentials:CNM, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8340 LAKEWOOD RANCH BLVD STE 240
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-5185
Mailing Address - Country:US
Mailing Address - Phone:941-907-3008
Mailing Address - Fax:
Practice Address - Street 1:4672 N SONOMA RANCH BLVD STE A
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-7271
Practice Address - Country:US
Practice Address - Phone:575-556-1879
Practice Address - Fax:575-556-1880
Is Sole Proprietor?:No
Enumeration Date:2012-04-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM711367A00000X
FLAPRN9340919367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM477563YRNDOtherMEDICARE
NM81428723Medicaid