Provider Demographics
NPI:1104894963
Name:BARRY, MARY ELIZABETH (ARNP)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ELIZABETH
Last Name:BARRY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:ELIZABETH
Other - Last Name:WHITWORTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:7244 BAILEY COVE RD SE STE B
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-2868
Mailing Address - Country:US
Mailing Address - Phone:256-261-3340
Mailing Address - Fax:
Practice Address - Street 1:12205 COUNTY LINE RD STE A2
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-7719
Practice Address - Country:US
Practice Address - Phone:256-325-6722
Practice Address - Fax:256-325-6724
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-120963363LF0000X, 363LF0000X
SC18562363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000388954OtherANTHEM BC BS FOR HHC
KY1228026OtherCHA HHC
KY000000493319OtherANTHEM BC BS APC
KY000000388954OtherANTHEM BC BS FOR HHC
KY000000493319OtherANTHEM BC BS APC
KY912229Medicare ID - Type UnspecifiedPARAGON FAMILY PRACTICE
KY1228026OtherCHA HHC