MEDICARE: CHARLOTTE BARRETT

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	363LF0000X	Family Nurse Practitioner	201590	OK

General Provider Information

NPI Number	:	1194300525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLOTTE BARRETT

Provider Business Mailing Address
First Line	:	461717 E 1033 RD
Second Line	:
City	:	SALLISAW
State	:	OK
Zip	:	74955-5166
Country	:	US
Telephone Number	:	918-571-3878
Fax Number	:

Provider Business Practice Location Address
First Line	:	511 E REDWOOD AVE
Second Line	:
City	:	SALLISAW
State	:	OK
Zip	:	74955-3020
Country	:	US
Telephone Number	:	918-775-1619
Fax Number	:

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

Provider Enumeration Date	:	03/17/2021
Last Update Date	:	10/01/2021

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Directions to “ CHARLOTTE BARRETT ” Practice Location

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