Provider Demographics
NPI:1194308437
Name:BARTON, KERISHA (ARNP)
Entity type:Individual
Prefix:
First Name:KERISHA
Middle Name:
Last Name:BARTON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1860 SW FOUNTAINVIEW BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-4528
Mailing Address - Country:US
Mailing Address - Phone:321-441-4118
Mailing Address - Fax:833-806-2188
Practice Address - Street 1:1860 SW FOUNTAINVIEW BLVD STE 100
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-4528
Practice Address - Country:US
Practice Address - Phone:321-441-4118
Practice Address - Fax:833-806-2188
Is Sole Proprietor?:No
Enumeration Date:2021-05-04
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11013001363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily