1568757979 NPI number — RENEE DRURY BARRETT CRNP

Table of content: RENEE DRURY BARRETT CRNP (NPI 1568757979)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568757979 NPI number — RENEE DRURY BARRETT CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARRETT
Provider First Name:
RENEE
Provider Middle Name:
DRURY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568757979
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/30/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 PEASANT VILLAGE LN
Provider Second Line Business Mailing Address:
STE 100
Provider Business Mailing Address City Name:
BELLE VERNON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15012-4333
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-929-7800
Provider Business Mailing Address Fax Number:
724-929-3229

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9970 MOUNTAIN VIEW DR
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
WEST MIFFLIN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15122-2474
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-653-3080
Provider Business Practice Location Address Fax Number:
412-650-8860
Provider Enumeration Date:
06/14/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  VP003026B , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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