Provider Demographics
NPI:1215062914
Name:BARRETT, CYNTHIA (APN CCNS)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:BARRETT
Suffix:
Gender:F
Credentials:APN CCNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 CROSSWINDS CT
Mailing Address - Street 2:
Mailing Address - City:JERSEYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62052-2057
Mailing Address - Country:US
Mailing Address - Phone:618-946-0540
Mailing Address - Fax:
Practice Address - Street 1:603 CROSSWINDS CT
Practice Address - Street 2:
Practice Address - City:JERSEYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62052-2057
Practice Address - Country:US
Practice Address - Phone:618-946-0540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-003200364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist