Provider Demographics
NPI:1932359395
Name:BARNETT, KERRY LEE (IDC)
Entity Type:Individual
Prefix:
First Name:KERRY
Middle Name:LEE
Last Name:BARNETT
Suffix:
Gender:F
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 827 BOX 33
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09617
Mailing Address - Country:US
Mailing Address - Phone:39081-811-6155
Mailing Address - Fax:
Practice Address - Street 1:PSC 827 BOX 33
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09617
Practice Address - Country:US
Practice Address - Phone:081-811-6155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman