MEDICARE: KRISTIN LEE BARRETT PMHNP-BC

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	ARNP2750002	FL

General Provider Information

NPI Number	:	1962988972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIN LEE BARRETT PMHNP-BC

Provider Business Mailing Address
First Line	:	12616 DEEDER LN
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32258-2157
Country	:	US
Telephone Number	:	904-994-0180
Fax Number	:	904-895-4729

Provider Business Practice Location Address
First Line	:	2520 UNIVERSITY BLVD W
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-2004
Country	:	US
Telephone Number	:	904-914-8947
Fax Number	:	904-895-4729

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

Provider Enumeration Date	:	07/12/2018
Last Update Date	:	01/23/2026

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