MEDICARE: MRS. COURTNEY LEE BARROW WHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	11028930	FL

General Provider Information

NPI Number	:	1770251480
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. COURTNEY LEE BARROW WHNP

Provider Business Mailing Address
First Line	:	362 STATE HIGHWAY 83
Second Line	:
City	:	DEFUNIAK SPRINGS
State	:	FL
Zip	:	32433-3800
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	362 STATE HIGHWAY 83
Second Line	:
City	:	DEFUNIAK SPRINGS
State	:	FL
Zip	:	32433-3800
Country	:	US
Telephone Number	:	850-892-8015
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2021
Last Update Date	:	01/16/2024

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