Provider Demographics
NPI:1396831186
Name:BARNETT, PEGGY DIANE (FNP)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:DIANE
Last Name:BARNETT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2023 LITTLE COVE RD
Mailing Address - Street 2:
Mailing Address - City:SEVIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37862-8515
Mailing Address - Country:US
Mailing Address - Phone:865-548-7827
Mailing Address - Fax:
Practice Address - Street 1:2023 LITTLE COVE RD
Practice Address - Street 2:
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-8515
Practice Address - Country:US
Practice Address - Phone:865-548-7827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN5637363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP95189Medicare UPIN