Provider Demographics
NPI:1235773029
Name:BARRETT, JUDY ROSE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:ROSE
Last Name:BARRETT
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 VALENCIA DR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-1858
Mailing Address - Country:US
Mailing Address - Phone:561-827-5847
Mailing Address - Fax:
Practice Address - Street 1:3385 BURNS RD STE 106
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4328
Practice Address - Country:US
Practice Address - Phone:561-691-0100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-04
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11004363363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner