Provider Demographics
NPI:1750318143
Name:BARNES, HEATHER M (CFNP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:M
Last Name:BARNES
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 REMINGTON DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39042-2829
Mailing Address - Country:US
Mailing Address - Phone:601-985-9355
Mailing Address - Fax:
Practice Address - Street 1:405 N HAYDEN ST
Practice Address - Street 2:
Practice Address - City:BELZONI
Practice Address - State:MS
Practice Address - Zip Code:39038-3639
Practice Address - Country:US
Practice Address - Phone:662-247-1254
Practice Address - Fax:662-247-4924
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS855922363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09280549Medicaid
MSQ19373Medicare UPIN