Basic Information
Provider Information
NPI: 1760807176
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARRETT
FirstName: VERONICA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CPNP-PC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 CHILDRENS PL
Address2:  
City: SAINT LOUIS
State: MO
PostalCode: 631101002
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1 CHILDRENS PL
Address2:  
City: SAINT LOUIS
State: MO
PostalCode: 631101002
CountryCode: US
TelephoneNumber: 3144546000
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/21/2014
LastUpdateDate: 05/19/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/19/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X2007019579MON Nursing Service ProvidersRegistered Nurse 
163W00000X041406061ILN Nursing Service ProvidersRegistered Nurse 
363LP0200X2014004555MOY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics

No ID Information.


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