Provider Demographics
NPI:1700152287
Name:FENTON, BARRIE ANNE
Entity Type:Individual
Prefix:
First Name:BARRIE
Middle Name:ANNE
Last Name:FENTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2780 HOMESTEAD RD
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048-5399
Mailing Address - Country:US
Mailing Address - Phone:775-727-0101
Mailing Address - Fax:775-727-0606
Practice Address - Street 1:2780 HOMESTEAD RD
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-5399
Practice Address - Country:US
Practice Address - Phone:775-727-0101
Practice Address - Fax:775-727-0606
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner