Provider Demographics
NPI:1922097385
Name:BARAKZAI, MARY D (FNP-C, CNM, CNS)
Entity Type:Individual
Prefix:PROF
First Name:MARY
Middle Name:D
Last Name:BARAKZAI
Suffix:
Gender:F
Credentials:FNP-C, CNM, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 E GRIFFITH WAY
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-4101
Mailing Address - Country:US
Mailing Address - Phone:559-229-0996
Mailing Address - Fax:
Practice Address - Street 1:350 E GRIFFITH WAY
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-4101
Practice Address - Country:US
Practice Address - Phone:559-229-0996
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9597363LF0000X
CA385364S00000X
CA116367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Not Answered364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Not Answered367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife