=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619842846
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BARNETT WELLNESS, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/07/2025
-----------------------------------------------------
Last Update Date | 01/30/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4425 JEFFERSON AVE STE 115
-----------------------------------------------------
City | TEXARKANA
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 71854-1529
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-309-1876
-----------------------------------------------------
Fax | 479-239-8415
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4425 JEFFERSON AVE STE 115
-----------------------------------------------------
City | TEXARKANA
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 71854-1529
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-309-1876
-----------------------------------------------------
Fax | 479-239-8415
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FOUNDER, CEO, NURSE PRACTITIONER
-----------------------------------------------------
Name | MR. GRANT MICHAEL BARNETT
-----------------------------------------------------
Credential | MNSC, APRN, PMHNP-BC
-----------------------------------------------------
Telephone | 903-748-6227
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------