Provider Demographics
NPI:1740375104
Name:BARRIOS, SALLY GENE (ARNP)
Entity type:Individual
Prefix:
First Name:SALLY
Middle Name:GENE
Last Name:BARRIOS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3913 CATES AVENUE
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:LA
Mailing Address - Zip Code:32310
Mailing Address - Country:US
Mailing Address - Phone:850-576-2418
Mailing Address - Fax:
Practice Address - Street 1:1801 MICCOSUKEE RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:LA
Practice Address - Zip Code:32308
Practice Address - Country:US
Practice Address - Phone:850-921-0330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP971532363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily