Provider Demographics
NPI:1801142179
Name:PAUL WESLEY BARRETT CFNP PLLC
Entity type:Organization
Organization Name:PAUL WESLEY BARRETT CFNP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFNP
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:WESLEY
Authorized Official - Last Name:BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:CFNP
Authorized Official - Phone:662-327-2921
Mailing Address - Street 1:321 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39705-1920
Mailing Address - Country:US
Mailing Address - Phone:662-327-2921
Mailing Address - Fax:662-328-6858
Practice Address - Street 1:321 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39705-1920
Practice Address - Country:US
Practice Address - Phone:662-327-2921
Practice Address - Fax:662-328-6858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-24
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR827931363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
302G507202Medicare PIN