Provider Demographics
NPI:1699072462
Name:BARRETT, STEFANIE KATHRYN (FNP-BC)
Entity type:Individual
Prefix:MS
First Name:STEFANIE
Middle Name:KATHRYN
Last Name:BARRETT
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:STEFANIE
Other - Middle Name:KATHRYN
Other - Last Name:WEINKAUF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:9 FULTON PL
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-1129
Mailing Address - Country:US
Mailing Address - Phone:860-593-0596
Mailing Address - Fax:
Practice Address - Street 1:151 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-3527
Practice Address - Country:US
Practice Address - Phone:860-951-1060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-14
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8615363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily