Basic Information
Provider Information
NPI: 1619520269
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARNETT
FirstName: KRISTA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 635283
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452635283
CountryCode: US
TelephoneNumber: 8593015901
FaxNumber: 8593015940
Practice Location
Address1: 820 DOLWICK DR
Address2:  
City: ERLANGER
State: KY
PostalCode: 410182774
CountryCode: US
TelephoneNumber: 8593015901
FaxNumber: 8593015940
Other Information
ProviderEnumerationDate: 07/23/2019
LastUpdateDate: 09/05/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X3013663KYY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
363LP0808X3013663KYN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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