MEDICARE: AMINATA BARRIE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	176466	GA

General Provider Information

NPI Number	:	1053035725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMINATA BARRIE

Provider Business Mailing Address
First Line	:	4775 PASTRY LN # 227
Second Line	:
City	:	ACWORTH
State	:	GA
Zip	:	30101-3488
Country	:	US
Telephone Number	:	678-357-8171
Fax Number	:

Provider Business Practice Location Address
First Line	:	4775 PASTRY LN # 227
Second Line	:
City	:	ACWORTH
State	:	GA
Zip	:	30101-3488
Country	:	US
Telephone Number	:	678-357-8171
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2022
Last Update Date	:	09/27/2022

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