Healthcare Provider Details

I. General information

NPI: 1548097579
Provider Name (Legal Business Name): ALEXIS BARNES APRN, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2024
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 SE FEDERAL HWY STE 334
STUART FL
34994-3839
US

IV. Provider business mailing address

7581 LINCOLN ST
HOLLYWOOD FL
33024-6838
US

V. Phone/Fax

Practice location:
  • Phone: 239-690-6906
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11035214
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: