Provider Demographics
NPI:1992011399
Name:BARRIE, FATMATA BINTA (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:FATMATA
Middle Name:BINTA
Last Name:BARRIE
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6501 VALLEY FORGE DR
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75089-5106
Mailing Address - Country:US
Mailing Address - Phone:972-971-0739
Mailing Address - Fax:
Practice Address - Street 1:6501 VALLEY FORGE DR
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75089-5106
Practice Address - Country:US
Practice Address - Phone:972-971-0739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-23
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX679074363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily