Provider Demographics
NPI:1316763212
Name:SINGLETON, BARRY DIRKSEN (PMHNP)
Entity type:Individual
Prefix:
First Name:BARRY
Middle Name:DIRKSEN
Last Name:SINGLETON
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:DIRK
Other - Middle Name:
Other - Last Name:SINGLETON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PMHNP
Mailing Address - Street 1:206 BLUE GRASS CIR SE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37323-0802
Mailing Address - Country:US
Mailing Address - Phone:423-432-1981
Mailing Address - Fax:
Practice Address - Street 1:928 NUUANU AVE STE 202
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-5190
Practice Address - Country:US
Practice Address - Phone:808-777-9460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN37680363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health