=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275637522
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BARBARA LATINIS BRIDGES ARNP ED D
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/08/2006
-----------------------------------------------------
Last Update Date | 09/17/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10875 GRANDVIEW ST BLDG 22, SUITE 2200
-----------------------------------------------------
City | OVERLAND PARK
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66210-1510
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-345-0060
-----------------------------------------------------
Fax | 913-345-0090
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6931 CHARLOTTE ST
-----------------------------------------------------
City | SHAWNEE
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66216-3926
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-631-9176
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 44482
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------