Individual
DR. PRUDENCE LYNN BARRETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2516 NILES AVE, SAINT JOSEPH, MI 49085-1937
(269) 983-6518
(269) 983-0955
Mailing address
2516 NILES AVE, SAINT JOSEPH, MI 49085-1937
(269) 983-6518
(269) 983-0955
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301044725
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1537773
—
MI
Enumeration date
09/26/2006
Last updated
07/08/2007
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