Provider Demographics
NPI:1528001765
Name:BARRETT, KASIE DEANN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:KASIE
Middle Name:DEANN
Last Name:BARRETT
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1413 CHATTANOOGA AVE
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-2631
Mailing Address - Country:US
Mailing Address - Phone:706-279-2635
Mailing Address - Fax:706-279-2679
Practice Address - Street 1:1413 CHATTANOOGA AVE
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-2631
Practice Address - Country:US
Practice Address - Phone:706-279-2635
Practice Address - Fax:706-279-2679
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20017363LF0000X
GARN149515363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GRP4720OtherGROUP #
GAGRP7341OtherGRP #
GRP4720OtherGROUP #