Provider Demographics
NPI:1275192593
Name:BARNETT, JENNIFER (FNP)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:BARNETT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:MEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:109 ROCKAWAY POINT BLVD
Mailing Address - Street 2:
Mailing Address - City:BREEZY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11697-1143
Mailing Address - Country:US
Mailing Address - Phone:917-371-8985
Mailing Address - Fax:
Practice Address - Street 1:109 ROCKAWAY POINT BLVD
Practice Address - Street 2:
Practice Address - City:BREEZY POINT
Practice Address - State:NY
Practice Address - Zip Code:11697-1143
Practice Address - Country:US
Practice Address - Phone:917-371-8985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF34440-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily