Healthcare Provider Details

I. General information

NPI: 1285360511
Provider Name (Legal Business Name): AUDREANNA BARNETT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2022
Last Update Date: 10/25/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98 RIVER ST
CLAY CITY KY
40312-1314
US

IV. Provider business mailing address

148 SKYVIEW DR
MT STERLING KY
40353-1496
US

V. Phone/Fax

Practice location:
  • Phone: 606-663-7788
  • Fax: 606-663-7785
Mailing address:
  • Phone: 859-499-0717
  • Fax: 859-499-0926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1136431
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: