Basic Information
| Provider Information | |||||||||
| NPI: | 1215538285 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARNETT | ||||||||
| FirstName: | MATTHEW | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 225 E WASHINGTON AVE | ||||||||
| Address2: | |||||||||
| City: | JONESBORO | ||||||||
| State: | AR | ||||||||
| PostalCode: | 724013111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8702074100 | ||||||||
| FaxNumber: | 8702076581 | ||||||||
| Practice Location | |||||||||
| Address1: | 63 DALTON DR | ||||||||
| Address2: | |||||||||
| City: | CAVE CITY | ||||||||
| State: | AR | ||||||||
| PostalCode: | 725219308 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8702832196 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/05/2020 | ||||||||
| LastUpdateDate: | 11/05/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | 212800 | AR | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.