=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801142179
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PAUL WESLEY BARRETT CFNP PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/24/2012
-----------------------------------------------------
Last Update Date | 09/06/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 321 HOSPITAL DR
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39705-1920
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 662-327-2921
-----------------------------------------------------
Fax | 662-328-6858
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 321 HOSPITAL DR
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39705-1920
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 662-327-2921
-----------------------------------------------------
Fax | 662-328-6858
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFNP
-----------------------------------------------------
Name | MR. PAUL WESLEY BARRETT
-----------------------------------------------------
Credential | CFNP
-----------------------------------------------------
Telephone | 662-327-2921
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | R827931
-----------------------------------------------------
License Number State | MS
-----------------------------------------------------