Healthcare Provider Details

I. General information

NPI: 1225243645
Provider Name (Legal Business Name): NANCIE ELIZABETH BARNETT FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 01/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1713 FAIRINGTON LN
MODESTO CA
95355-1543
US

IV. Provider business mailing address

1713 FAIRINGTON LN
MODESTO CA
95355-1543
US

V. Phone/Fax

Practice location:
  • Phone: 209-262-0734
  • Fax:
Mailing address:
  • Phone: 209-262-0734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberNP 11939
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP11939
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: