Provider Demographics
NPI:1043648140
Name:BARNETT, ANDRIETTA WRIGHT (DNP FNP-C PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ANDRIETTA
Middle Name:WRIGHT
Last Name:BARNETT
Suffix:
Gender:F
Credentials:DNP FNP-C PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1024 CANE BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:WALTERBORO
Mailing Address - State:SC
Mailing Address - Zip Code:29488-0802
Mailing Address - Country:US
Mailing Address - Phone:843-670-1434
Mailing Address - Fax:843-538-2837
Practice Address - Street 1:2300 W SAHARA AVE STE 800
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-4397
Practice Address - Country:US
Practice Address - Phone:203-666-8145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-29
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18546363LF0000X, 363LP0808X
MARN2330590363LP0808X
WAAP61264739363LP0808X
NV822183363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1043648140Medicaid
SCNP2692Medicaid