Provider Demographics
NPI:1033103395
Name:BARRETO, MARY JO (APRN-BC)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:JO
Last Name:BARRETO
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 PALMYRA DR
Mailing Address - Street 2:
Mailing Address - City:TEGA CAY
Mailing Address - State:SC
Mailing Address - Zip Code:29708-8568
Mailing Address - Country:US
Mailing Address - Phone:803-547-2250
Mailing Address - Fax:
Practice Address - Street 1:WINTHROP UNIVERSITY HEALTH SERVICES
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29733-0001
Practice Address - Country:US
Practice Address - Phone:803-323-2206
Practice Address - Fax:803-323-3332
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-01
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCF89363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily