Healthcare Provider Details

I. General information

NPI: 1992951768
Provider Name (Legal Business Name): BRIDGET DIXON BARNETT CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2008
Last Update Date: 10/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 MONTLIMAR DR
MOBILE AL
36609-1713
US

IV. Provider business mailing address

5750A SOUTHLAND DR
MOBILE AL
36693-3316
US

V. Phone/Fax

Practice location:
  • Phone: 251-662-7316
  • Fax: 251-706-5596
Mailing address:
  • Phone: 251-662-7316
  • Fax: 251-662-7297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number1-109071
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1-109071
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1-109071
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: