Provider Demographics
NPI:1578819009
Name:BARRETT, KRISTINE GAYLE (ARNP)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:GAYLE
Last Name:BARRETT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KRISTINE
Other - Middle Name:GAYLE
Other - Last Name:BURNS, BORLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1050 LOVELAND BLVD
Mailing Address - Street 2:CARE HERE CHARLOTTE COUNTY HEALTH CENTER
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33980-1836
Mailing Address - Country:US
Mailing Address - Phone:877-423-1330
Mailing Address - Fax:941-764-0259
Practice Address - Street 1:1050 LOVELAND BLVD
Practice Address - Street 2:CARE HERE CHARLOTTE COUNTY HEALTH CENTER
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33980-1836
Practice Address - Country:US
Practice Address - Phone:877-423-1330
Practice Address - Fax:941-764-0259
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-02
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9170048363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily