Provider Demographics
NPI:1346232444
Name:BARTLETT, GENIE (RN, FNP)
Entity Type:Individual
Prefix:MS
First Name:GENIE
Middle Name:
Last Name:BARTLETT
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 E MARSHALL AVE
Mailing Address - Street 2:SUITE 1002
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-5573
Mailing Address - Country:US
Mailing Address - Phone:903-247-7700
Mailing Address - Fax:903-238-9185
Practice Address - Street 1:705 E MARSHALL AVE STE 1002
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-5660
Practice Address - Country:US
Practice Address - Phone:903-247-7700
Practice Address - Fax:903-238-9185
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX429590363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ28771Medicare UPIN