Provider Demographics
NPI:1285747121
Name:BARNES, SUSAN MCGRAW (FNP, APRN-BC)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:MCGRAW
Last Name:BARNES
Suffix:
Gender:F
Credentials:FNP, APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420E 2ND AVE 103
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30161-3210
Mailing Address - Country:US
Mailing Address - Phone:706-509-3278
Mailing Address - Fax:
Practice Address - Street 1:160 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:TRION
Practice Address - State:GA
Practice Address - Zip Code:30753-1125
Practice Address - Country:US
Practice Address - Phone:706-734-7302
Practice Address - Fax:706-734-7356
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN105904363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
381016OtherWELLCARE
GA574013599BMedicaid
381016OtherWELLCARE
GA574013599BMedicaid
GA511I500081Medicare PIN