Provider Demographics
NPI:1679029912
Name:BARRETT, AMANDA MCALLISTER (RN)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:MCALLISTER
Last Name:BARRETT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:MCALLISTER
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2144 45TH AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-4721
Mailing Address - Country:US
Mailing Address - Phone:845-807-3480
Mailing Address - Fax:
Practice Address - Street 1:21-44 45TH AVE APT 4
Practice Address - Street 2:
Practice Address - City:LIC
Practice Address - State:NY
Practice Address - Zip Code:11101-4721
Practice Address - Country:US
Practice Address - Phone:845-807-3480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-28
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY596593163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse