Provider Demographics
NPI:1235956020
Name:BARRETT, MICHELLE B (APRN)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:B
Last Name:BARRETT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4850 N STATE ROAD 7 STE 101G
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33319-5807
Mailing Address - Country:US
Mailing Address - Phone:954-224-6465
Mailing Address - Fax:
Practice Address - Street 1:4850 N STATE ROAD 7 STE 101G
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33319-5807
Practice Address - Country:US
Practice Address - Phone:954-224-6465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11026677363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner