Provider Demographics
NPI:1609377555
Name:BARRETTE, KATHLEEN LISA
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:LISA
Last Name:BARRETTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1064
Mailing Address - Street 2:
Mailing Address - City:CALIENTE
Mailing Address - State:NV
Mailing Address - Zip Code:89008-1064
Mailing Address - Country:US
Mailing Address - Phone:775-962-2282
Mailing Address - Fax:
Practice Address - Street 1:550 W PIONEER BLVD STE 204
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:NV
Practice Address - Zip Code:89027-1406
Practice Address - Country:US
Practice Address - Phone:702-345-4065
Practice Address - Fax:702-345-4077
Is Sole Proprietor?:No
Enumeration Date:2018-02-26
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No376J00000XNursing Service Related ProvidersHomemaker