Provider Demographics
NPI:1922770916
Name:BARNARD, LARRY BRYANT JR (FNP-C)
Entity type:Individual
Prefix:
First Name:LARRY
Middle Name:BRYANT
Last Name:BARNARD
Suffix:JR
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 JACOB LN
Mailing Address - Street 2:
Mailing Address - City:KILLINGWORTH
Mailing Address - State:CT
Mailing Address - Zip Code:06419-1185
Mailing Address - Country:US
Mailing Address - Phone:843-441-2829
Mailing Address - Fax:
Practice Address - Street 1:1 LONG WHARF DR
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5991
Practice Address - Country:US
Practice Address - Phone:203-785-2807
Practice Address - Fax:203-785-2807
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-29
Last Update Date:2025-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN278883363LF0000X
CT214166363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT214166OtherCONNECTICUT BOARD OF NURSING
GARN278883OtherGEORGIA BOARD OF NURSING