Healthcare Provider Details

I. General information

NPI: 1508364738
Provider Name (Legal Business Name): COURTNEY MCINTYRE BARNETT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2018
Last Update Date: 01/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2705 MEDICAL OFFICE PL
GOLDSBORO NC
27534-9458
US

IV. Provider business mailing address

1735 WALNUT RUN DR
DEEP RUN NC
28525-9498
US

V. Phone/Fax

Practice location:
  • Phone: 919-731-2526
  • Fax: 919-580-0988
Mailing address:
  • Phone: 252-521-3392
  • Fax: 919-580-0988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5010196
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: