Provider Demographics
NPI:1023429982
Name:CARVETH, BARRIE GLEASON (NP)
Entity type:Individual
Prefix:
First Name:BARRIE
Middle Name:GLEASON
Last Name:CARVETH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 79777
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21279-0777
Mailing Address - Country:US
Mailing Address - Phone:434-654-7794
Mailing Address - Fax:844-883-6065
Practice Address - Street 1:435 MERCHANT WALK SQ
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902
Practice Address - Country:US
Practice Address - Phone:434-654-1800
Practice Address - Fax:844-883-6065
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-14
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024074901363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVVM018AMedicare PIN