Provider Demographics
NPI:1831643170
Name:BARRETT, DAVID (ARNP)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:BARRETT
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4949 HICKORY TREE LN APT 305
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-2367
Mailing Address - Country:US
Mailing Address - Phone:863-651-2985
Mailing Address - Fax:
Practice Address - Street 1:4949 HICKORY TREE LN APT 305
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-2367
Practice Address - Country:US
Practice Address - Phone:863-651-2985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-03
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10636363LA2100X
FLAPRN9286750363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care