Healthcare Provider Details

I. General information

NPI: 1467435057
Provider Name (Legal Business Name): PATRICK JOHN BARROW MSN/FNP, NP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/28/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 HARNELL AVE
REDDING CA
96002
US

IV. Provider business mailing address

1020 JAXON WAY
REDDING CA
96003-4407
US

V. Phone/Fax

Practice location:
  • Phone: 530-226-7659
  • Fax:
Mailing address:
  • Phone: 530-246-3218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberNP 10590
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: