Provider Demographics
NPI:1275121295
Name:BARRETT, KATIE ROSSILYN (RN)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:ROSSILYN
Last Name:BARRETT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:ROSSILYN
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:224 N 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-2313
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:401 BUSTER RD
Practice Address - Street 2:
Practice Address - City:TOPPENISH
Practice Address - State:WA
Practice Address - Zip Code:98948-9792
Practice Address - Country:US
Practice Address - Phone:509-865-2102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60791586163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse