Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 903358 | MS |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 903358 | MS |
NPI | 1578124186 |
---|---|
Provider Name | Casie Barnes |
First Address | Hattiesburg, MS 39401-7246 |
Second Address | Hattiesburg, MS 39401-7246 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2019 |
Last Update Date | 22/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
08608247 | (05) | MS |