Provider Demographics
NPI:1841269230
Name:BARRETT, CATHERINE M (NP)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:M
Last Name:BARRETT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 GUTHRIE SQ
Mailing Address - Street 2:
Mailing Address - City:SAYRE
Mailing Address - State:PA
Mailing Address - Zip Code:18840-1625
Mailing Address - Country:US
Mailing Address - Phone:570-888-5858
Mailing Address - Fax:
Practice Address - Street 1:285 GUTHRIE DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:PA
Practice Address - Zip Code:16947-8115
Practice Address - Country:US
Practice Address - Phone:570-297-4104
Practice Address - Fax:570-297-2066
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP003220D208000000X, 363L00000X
NYF380660-1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAGU040074OtherMEDICARE GROUP
PA500001534OtherRR MEDICARE
NY01721411Medicaid
PACC9269OtherRR MEDICARE GROUP
S10450Medicare UPIN
PAGU040074OtherMEDICARE GROUP