Healthcare Provider Details

I. General information

NPI: 1104894963
Provider Name (Legal Business Name): MARY ELIZABETH BARRY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARY ELIZABETH WHITWORTH ARNP

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 08/30/2022
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12205 COUNTY LINE RD STE A2
MADISON AL
35758-7719
US

IV. Provider business mailing address

7244 BAILEY COVE RD SE STE B
HUNTSVILLE AL
35802-2868
US

V. Phone/Fax

Practice location:
  • Phone: 256-325-6722
  • Fax: 256-325-6724
Mailing address:
  • Phone: 256-261-3340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-120963
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: