Healthcare Provider Details

I. General information

NPI: 1659319945
Provider Name (Legal Business Name): COLLEEN R BESSETTI-BARRETT CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 01/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 N MERCER ST
LINESVILLE PA
16424-9232
US

IV. Provider business mailing address

210 N MERCER ST PO BOX 365
LINESVILLE PA
16424-9232
US

V. Phone/Fax

Practice location:
  • Phone: 814-683-4636
  • Fax: 814-683-5869
Mailing address:
  • Phone: 814-683-4636
  • Fax: 814-683-5869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberUP007011B
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: