Provider Demographics
NPI:1639359417
Name:BARNETT, MICHELLE L (NP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:L
Last Name:BARNETT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13838S 46TH PL 320
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-7804
Mailing Address - Country:US
Mailing Address - Phone:480-759-5151
Mailing Address - Fax:
Practice Address - Street 1:1343 N ALMA SCHOOL RD STE 160
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-5901
Practice Address - Country:US
Practice Address - Phone:480-963-1853
Practice Address - Fax:480-963-1854
Is Sole Proprietor?:No
Enumeration Date:2007-11-08
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22049363L00000X
AZAP5012363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner