Healthcare Provider Details

I. General information

NPI: 1538196332
Provider Name (Legal Business Name): LISA K BARNES ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 NORTH HUSER
SYRACUSE KS
67878-1278
US

IV. Provider business mailing address

PO BOX 1278
SYRACUSE KS
67878-1278
US

V. Phone/Fax

Practice location:
  • Phone: 620-384-7350
  • Fax: 620-384-7370
Mailing address:
  • Phone: 620-384-7350
  • Fax: 620-384-7370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number45866
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: