Healthcare Provider Details

I. General information

NPI: 1497983175
Provider Name (Legal Business Name): RITA M BARRETT NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2009
Last Update Date: 02/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8920 OTTERBURN ROAD
AMELIA VA
23002
US

IV. Provider business mailing address

PO BOX 70
VICTORIA VA
23974-0070
US

V. Phone/Fax

Practice location:
  • Phone: 804-561-5150
  • Fax: 804-561-6643
Mailing address:
  • Phone: 434-696-2165
  • Fax: 434-696-1557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024168362
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: