Healthcare Provider Details

I. General information

NPI: 1669612487
Provider Name (Legal Business Name): ERIC JASON BARRETT CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2009
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 OLD HIGHWAY 92
LEIGHTON IA
50143-8065
US

IV. Provider business mailing address

1175 OLD HIGHWAY 92
LEIGHTON IA
50143-8065
US

V. Phone/Fax

Practice location:
  • Phone: 641-660-1695
  • Fax:
Mailing address:
  • Phone: 641-660-1695
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberD115174
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: