Provider Demographics
NPI:1861402414
Name:BARNETT, SHIRLEY R (FNP, CNS)
Entity type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:R
Last Name:BARNETT
Suffix:
Gender:F
Credentials:FNP, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 TOWNSHIP ROAD 375
Mailing Address - Street 2:
Mailing Address - City:TORONTO
Mailing Address - State:OH
Mailing Address - Zip Code:43964-7984
Mailing Address - Country:US
Mailing Address - Phone:740-283-1363
Mailing Address - Fax:740-284-0060
Practice Address - Street 1:905 TOWNSHIP ROAD 375
Practice Address - Street 2:
Practice Address - City:TORONTO
Practice Address - State:OH
Practice Address - Zip Code:43964-7984
Practice Address - Country:US
Practice Address - Phone:740-283-1363
Practice Address - Fax:740-284-0060
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN138645101YM0800X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily