Provider Demographics
NPI:1245238476
Name:BARLETTA, GINA MARIE (MS, PA-C)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:MARIE
Last Name:BARLETTA
Suffix:
Gender:F
Credentials:MS, PA-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 306556
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37230-6556
Mailing Address - Country:US
Mailing Address - Phone:615-329-2294
Mailing Address - Fax:615-695-1494
Practice Address - Street 1:8 CITY BLVD STE 300
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-2560
Practice Address - Country:US
Practice Address - Phone:615-329-6600
Practice Address - Fax:615-321-6226
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1677363A00000X
363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4339223OtherBCBS TN PA
TN1510379Medicaid
TN6006673OtherBCBS TN PAAS
TN6006673OtherBCBS TN PAAS
TN1510379Medicaid
PAP81979Medicare UPIN