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NPI Code Detail

MEDICARE: MADISON VIRGINIA BARRETT

MEDICARE: MADISON VIRGINIA 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
1363LF0000XFamily Nurse Practitioner905638MS

General Provider Information

NPI Number : 1972219947
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADISON VIRGINIA BARRETT
Provider Business Mailing Address
First Line : 1190 N STATE ST STE 2A
Second Line :
City : JACKSON
State : MS
Zip : 39202-2413
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 778 LIBERTY RD
Second Line :
City : FLOWOOD
State : MS
Zip : 39232-9300
Country : US
Telephone Number : 769-243-6141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2023
Last Update Date : 05/27/2026

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Directions to “ MADISON VIRGINIA BARRETT ” Practice Location

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