Provider Demographics
NPI:1629853544
Name:BARNES COREY, CONTESTA LASSHURA (FNP-C)
Entity Type:Individual
Prefix:
First Name:CONTESTA
Middle Name:LASSHURA
Last Name:BARNES COREY
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 1:618 PEGRAM DR
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-6322
Mailing Address - Country:US
Mailing Address - Phone:662-844-6513
Mailing Address - Fax:662-260-3799
Practice Address - Street 1:618 PEGRAM DR
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-6322
Practice Address - Country:US
Practice Address - Phone:662-844-6513
Practice Address - Fax:662-260-3799
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2023-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS906227363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner