Healthcare Provider Details

I. General information

NPI: 1326556713
Provider Name (Legal Business Name): MICHELE MARIE BARNETT PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2018
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 5TH ST SE
CEDAR RAPIDS IA
52401-2158
US

IV. Provider business mailing address

214 BROOKS DR
TOWNVILLE SC
29689-3402
US

V. Phone/Fax

Practice location:
  • Phone: 319-398-3562
  • Fax:
Mailing address:
  • Phone: 727-580-0564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberG151374
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier023683000
Identifier TypeMEDICAID
Identifier StateFL
Identifier IssuerFlorida Medicaid Provider ID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: