Provider Demographics
NPI:1558053835
Name:BARRETT, MERVERLYN ANN MARIE (LPN)
Entity Type:Individual
Prefix:
First Name:MERVERLYN
Middle Name:ANN MARIE
Last Name:BARRETT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 ASHFORD ST
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06120-1104
Mailing Address - Country:US
Mailing Address - Phone:860-502-8153
Mailing Address - Fax:
Practice Address - Street 1:75 ASHFORD ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06120-1104
Practice Address - Country:US
Practice Address - Phone:860-502-8153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTNA88598163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty