Provider Demographics
NPI:1508223850
Name:BARNES, QUINTON (NP-C)
Entity Type:Individual
Prefix:
First Name:QUINTON
Middle Name:
Last Name:BARNES
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4626 RIDGEGATE DR
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CORNERS
Mailing Address - State:GA
Mailing Address - Zip Code:30097-2376
Mailing Address - Country:US
Mailing Address - Phone:770-733-0075
Mailing Address - Fax:
Practice Address - Street 1:4626 RIDGEGATE DR
Practice Address - Street 2:
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30097-2376
Practice Address - Country:US
Practice Address - Phone:770-733-0075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-18
Last Update Date:2016-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN188321363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily