Provider Demographics
NPI:1164962288
Name:BARNES, SANGDUAN (FNP-C)
Entity Type:Individual
Prefix:
First Name:SANGDUAN
Middle Name:
Last Name:BARNES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 697
Mailing Address - Street 2:
Mailing Address - City:BOAZ
Mailing Address - State:AL
Mailing Address - Zip Code:35957-0697
Mailing Address - Country:US
Mailing Address - Phone:256-840-8181
Mailing Address - Fax:256-744-7290
Practice Address - Street 1:2986 US HIGHWAY 431
Practice Address - Street 2:
Practice Address - City:BOAZ
Practice Address - State:AL
Practice Address - Zip Code:35957-5848
Practice Address - Country:US
Practice Address - Phone:256-840-8181
Practice Address - Fax:256-744-7272
Is Sole Proprietor?:No
Enumeration Date:2017-03-08
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN264897363LF0000X
AL1-122021363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily