Provider Demographics
NPI:1699507137
Name:BARRETT, KAYDENCE (PRSS)
Entity type:Individual
Prefix:
First Name:KAYDENCE
Middle Name:
Last Name:BARRETT
Suffix:
Gender:F
Credentials:PRSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 S MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:FAIRLAND
Mailing Address - State:OK
Mailing Address - Zip Code:74343-4914
Mailing Address - Country:US
Mailing Address - Phone:479-220-5890
Mailing Address - Fax:
Practice Address - Street 1:104 S MAPLE ST
Practice Address - Street 2:
Practice Address - City:FAIRLAND
Practice Address - State:OK
Practice Address - Zip Code:74343-4914
Practice Address - Country:US
Practice Address - Phone:479-220-5890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist