Provider Demographics
NPI:1558086157
Name:BARRATT, SUSAN MARIE (FNP-C)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:MARIE
Last Name:BARRATT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1241 KIRBY CIR
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-5687
Mailing Address - Country:US
Mailing Address - Phone:443-866-4525
Mailing Address - Fax:
Practice Address - Street 1:300 THE FENWAY
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5820
Practice Address - Country:US
Practice Address - Phone:443-866-4525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR182263363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily