Provider Demographics
NPI:1447321575
Name:BARRETT, ANITA A (LPN)
Entity type:Individual
Prefix:MS
First Name:ANITA
Middle Name:A
Last Name:BARRETT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 FALLS BLVD
Mailing Address - Street 2:
Mailing Address - City:CHITTENANGO
Mailing Address - State:NY
Mailing Address - Zip Code:13037-1812
Mailing Address - Country:US
Mailing Address - Phone:315-510-3098
Mailing Address - Fax:
Practice Address - Street 1:425 FALLS BLVD
Practice Address - Street 2:
Practice Address - City:CHITTENANGO
Practice Address - State:NY
Practice Address - Zip Code:13037-1812
Practice Address - Country:US
Practice Address - Phone:315-510-3098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY261337-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse