Individual
LISA BARRETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2525 COURT DR, GASTONIA, NC 28054-2140
(704) 834-2825
Mailing address
PO BOX 12845, GASTONIA, NC 28052-0017
(704) 864-8772
(704) 866-7853
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
159572
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260537
MEDICARE ID
NC
01
—
430073305
RR MEDICARE
NC
05
—
8051584
—
NC
05
—
NAN456
—
SC
Enumeration date
07/05/2006
Last updated
12/03/2014
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