Basic Information
Provider Information
NPI: 1912581646
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MONROE
FirstName: KRISTI
MiddleName: BARNES
NamePrefix:  
NameSuffix:  
Credential: PMHNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 24 CLAY ST
Address2:  
City: MARTINSVILLE
State: VA
PostalCode: 241122810
CountryCode: US
TelephoneNumber: 2766327128
FaxNumber:  
Practice Location
Address1: 24 CLAY ST
Address2:  
City: MARTINSVILLE
State: VA
PostalCode: 241122810
CountryCode: US
TelephoneNumber: 2766327128
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/10/2021
LastUpdateDate: 01/20/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/20/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0808X0024181029VAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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