MEDICARE: MRS. NANCY SUZANNAH BARNETTE CRNP

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	364SF0001X	Family Health Clinical Nurse Specialist	207Q00000X	AL

General Provider Information

NPI Number	:	1689869026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NANCY SUZANNAH BARNETTE CRNP

Provider Business Mailing Address
First Line	:	7104 UNIVERSITY CT
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36117-8045
Country	:	US
Telephone Number	:	334-215-0711
Fax Number	:	334-215-0710

Provider Business Practice Location Address
First Line	:	7104 UNIVERSITY CT
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36117-8045
Country	:	US
Telephone Number	:	334-215-0711
Fax Number	:	334-215-0710

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

Provider Enumeration Date	:	09/10/2007
Last Update Date	:	09/10/2007

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