Healthcare Provider Details

I. General information

NPI: 1881917987
Provider Name (Legal Business Name): KRISTY WALTON BARRENTINE ACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2010
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 DAPHNE AVE
DAPHNE AL
36526-4298
US

IV. Provider business mailing address

1505 DAPHNE AVE
DAPHNE AL
36526-4298
US

V. Phone/Fax

Practice location:
  • Phone: 251-625-2663
  • Fax: 251-625-3198
Mailing address:
  • Phone: 251-625-2663
  • Fax: 251-625-3198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number1-119140
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: