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General NPI Number Information
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NPI Number | 1407547193
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Entity Type | Individual
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Provider Name | BARRETT MICHAEL ALLEN FNP-C
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Gender | Male
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Dates
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Enumeration Date | 05/15/2023
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Last Update Date | 05/15/2023
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Provider Practice Location Address
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Address Line | 314 WEST 16TH STREET
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City | PUEBLO
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State | CO
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Zip | 81003
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Country | US
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Telephone | 719-544-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 814 TENDERFOOT HILL ROAD APT 202
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906
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Country | US
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Telephone | 713-377-8177
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | C-RXN.0100425-C-NP
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License Number State | CO
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