Provider Demographics
NPI:1912111212
Name:BARRETT, MARYN L
Entity Type:Individual
Prefix:
First Name:MARYN
Middle Name:L
Last Name:BARRETT
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 1:121 MAPLE STREET
Mailing Address - Street 2:
Mailing Address - City:EAST ANDOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03231
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15 AIKEN AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NH
Practice Address - Zip Code:03235-1259
Practice Address - Country:US
Practice Address - Phone:603-934-2060
Practice Address - Fax:603-934-1460
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2843183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist