Provider Demographics
NPI:1265865265
Name:BARRETT, CAROLINE ANNE (CNP)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:ANNE
Last Name:BARRETT
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:ANNE
Other - Last Name:WYMA-TSCHOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1338 PARK DR
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005-2046
Mailing Address - Country:US
Mailing Address - Phone:360-720-4374
Mailing Address - Fax:
Practice Address - Street 1:210 W LAS CRUCES AVE
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-1804
Practice Address - Country:US
Practice Address - Phone:575-288-9994
Practice Address - Fax:575-525-3703
Is Sole Proprietor?:No
Enumeration Date:2013-08-13
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-02330363LF0000X
WAAP60399117207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM54430267Medicaid
NMNPI & TIN#OtherBCBS OF NM
NMNPI & TIN#OtherBCBS OF NM