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NPI Code Detail

MEDICARE: MISS TORI LYN BARNES PA

MEDICARE: MISS TORI LYN BARNES PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant085004096IL
2363A00000XPhysician Assistant15-01934KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1085004096OTHERILILLINOIS PHYSICIAN ASSISTANT LICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
350.003148OTHEROHMEDICAL LICENSE NUMBER

General Provider Information

NPI Number : 1508176983
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS TORI LYN BARNES PA
Provider Business Mailing Address
First Line : 7550 W VILLAGE CIR STE 1
Second Line :
City : WICHITA
State : KS
Zip : 67205-9364
Country : US
Telephone Number : 316-838-2020
Fax Number : 316-838-7574
Provider Business Practice Location Address
First Line : 7550 W VILLAGE CIR STE 1
Second Line :
City : WICHITA
State : KS
Zip : 67205-9364
Country : US
Telephone Number : 316-838-2020
Fax Number : 316-838-7574
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2010
Last Update Date : 03/17/2018

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Directions to “ MISS TORI LYN BARNES PA” Practice Location

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