Healthcare Provider Details

I. General information

NPI: 1285747121
Provider Name (Legal Business Name): SUSAN MCGRAW BARNES FNP, APRN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 07/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 CENTRAL AVE
TRION GA
30753-1125
US

IV. Provider business mailing address

420E 2ND AVE 103
ROME GA
30161-3210
US

V. Phone/Fax

Practice location:
  • Phone: 706-734-7302
  • Fax: 706-734-7356
Mailing address:
  • Phone: 706-509-3278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN105904
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: