Provider Demographics
NPI:1689768954
Name:BARRETT, LYDIA ROXANNE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:LYDIA
Middle Name:ROXANNE
Last Name:BARRETT
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:793 JAY BARRETT RD
Mailing Address - Street 2:
Mailing Address - City:HIHWASSEE
Mailing Address - State:GA
Mailing Address - Zip Code:30546
Mailing Address - Country:US
Mailing Address - Phone:709-896-3821
Mailing Address - Fax:
Practice Address - Street 1:TOWNS COUNTY HEALTH DEPARTMENT
Practice Address - Street 2:1104 JACK DAYTON CIRCLE
Practice Address - City:YOUNG HARIS
Practice Address - State:GA
Practice Address - Zip Code:30582
Practice Address - Country:US
Practice Address - Phone:706-896-2265
Practice Address - Fax:706-896-1816
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN045180363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology