Provider Demographics
NPI:1720537335
Name:BARRETT, CYNTHIA RENNE' (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:RENNE'
Last Name:BARRETT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MRS
Other - First Name:CYNTHIA
Other - Middle Name:RENEE'
Other - Last Name:BARRETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:PO BOX 8021
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36110-0021
Mailing Address - Country:US
Mailing Address - Phone:334-239-4957
Mailing Address - Fax:334-593-1702
Practice Address - Street 1:1231 PERRY HILL ROAD
Practice Address - Street 2:SUITE C
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36109
Practice Address - Country:US
Practice Address - Phone:334-239-4957
Practice Address - Fax:334-593-1702
Is Sole Proprietor?:No
Enumeration Date:2016-09-23
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-117172363LF0000X, 363LP2300X, 363LX0106X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1-117172OtherLICENSE #
AL5025477818OtherNRCME
2016015252OtherANCC-CRNP