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General NPI Number Information
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NPI Number | 1215340096
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Entity Type | Organization
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Legal Business Name | BARRETT CLINIC PC
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Dates
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Enumeration Date | 06/09/2014
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Last Update Date | 11/01/2023
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Provider Practice Location Address
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Address Line | 8074 S 84TH ST
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City | LA VISTA
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State | NE
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Zip | 68128-3303
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Country | US
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Telephone | 402-991-9500
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Fax | 402-991-9564
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Provider Business Mailing Address
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Address Line | 8074 S 84TH ST
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City | LA VISTA
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State | NE
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Zip | 68128-3303
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Country | US
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Telephone | 402-991-9500
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Fax | 402-991-9564
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Authorized Official
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Title or Position | CEO/OWNER/FOUNDER
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Name | MR. MITCHELL LEE BARRETT
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Credential | APRN
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Telephone | 402-991-9500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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