Provider Demographics
NPI:1881917987
Name:BARRENTINE, KRISTY WALTON (ACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:WALTON
Last Name:BARRENTINE
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1469
Mailing Address - Street 2:
Mailing Address - City:PASCAGOULA
Mailing Address - State:MS
Mailing Address - Zip Code:39568-1469
Mailing Address - Country:US
Mailing Address - Phone:228-938-0700
Mailing Address - Fax:228-938-0705
Practice Address - Street 1:4105 HOSPITAL ST
Practice Address - Street 2:SUITE 112B
Practice Address - City:PASCAGOULA
Practice Address - State:MS
Practice Address - Zip Code:39581-5312
Practice Address - Country:US
Practice Address - Phone:228-938-0700
Practice Address - Fax:228-938-0705
Is Sole Proprietor?:No
Enumeration Date:2010-03-04
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR869997363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine