Provider Demographics
NPI:1194199505
Name:KATHLEEN BARRY ARNP LLC
Entity type:Organization
Organization Name:KATHLEEN BARRY ARNP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BARRY
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP-C
Authorized Official - Phone:813-523-1926
Mailing Address - Street 1:2510 HIGH OAKS LN
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33559-3711
Mailing Address - Country:US
Mailing Address - Phone:813-903-2351
Mailing Address - Fax:
Practice Address - Street 1:2510 HIGH OAKS LN
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33559-3711
Practice Address - Country:US
Practice Address - Phone:813-903-2351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-23
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363LF0000X
FLARNP9277039314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty