Healthcare Provider Details

I. General information

NPI: 1265634042
Provider Name (Legal Business Name): SIEDA BARROW APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 05/31/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 BURBANK DR NW
ATLANTA GA
30314-2416
US

IV. Provider business mailing address

80 BURBANK DR NW
ATLANTA GA
30314-2416
US

V. Phone/Fax

Practice location:
  • Phone: 267-975-6765
  • Fax:
Mailing address:
  • Phone: 267-975-6765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP015976
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN-NP288948
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: