Healthcare Provider Details

I. General information

NPI: 1447400064
Provider Name (Legal Business Name): CHASTITY A BARNETTE CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2008
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

814 WINDSOR RD
GRENADA MS
38901-5026
US

IV. Provider business mailing address

814 WINDSOR RD
GRENADA MS
38901-5026
US

V. Phone/Fax

Practice location:
  • Phone: 662-809-5738
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number855540
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: