MEDICARE: MARY M. BARNETT CNM, APRN

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	364SW0102X	Women's Health Clinical Nurse Specialist	232732	TX
2	367A00000X	Advanced Practice Midwife	232732	TX

General Provider Information

NPI Number	:	1194876771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY M. BARNETT CNM, APRN

Provider Business Mailing Address
First Line	:	1704 TREADWELL ST.
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704
Country	:	US
Telephone Number	:	512-771-2205
Fax Number	:	866-497-7994

Provider Business Practice Location Address
First Line	:	1704 TREADWELL ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-2146
Country	:	US
Telephone Number	:	512-444-4893
Fax Number	:	866-497-7994

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

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	06/29/2020

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