Provider Demographics
NPI:1205933876
Name:BARNETT, TONI ODOM (PHD, FNP-C)
Entity type:Individual
Prefix:DR
First Name:TONI
Middle Name:ODOM
Last Name:BARNETT
Suffix:
Gender:F
Credentials:PHD, FNP-C
Other - Prefix:
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Mailing Address - Street 1:165 BLUE RIDGE OVERLOOK
Mailing Address - Street 2:
Mailing Address - City:BLUE RIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30513-4431
Mailing Address - Country:US
Mailing Address - Phone:706-946-5600
Mailing Address - Fax:706-374-7628
Practice Address - Street 1:134 ANSLEY DR
Practice Address - Street 2:SUITE 200
Practice Address - City:DAHLONEGA
Practice Address - State:GA
Practice Address - Zip Code:30533-1640
Practice Address - Country:US
Practice Address - Phone:706-864-2155
Practice Address - Fax:706-374-7628
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN060038363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN060038OtherNP LICENSE
GA003130707AMedicaid
GA202I508951OtherMEDICARE PTAN
GA003130707CMedicaid
GA003130707CMedicaid