MEDICARE: DR. GABRIEL ANNE BARGEN PH.D.

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
1	231H00000X	Audiologist	2133	KS

General Provider Information

NPI Number	:	1194917567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GABRIEL ANNE BARGEN PH.D.

Provider Business Mailing Address
First Line	:	1000 SUNNYSIDE AVE
Second Line	:	3001 DOLE
City	:	LAWRENCE
State	:	KS
Zip	:	66045-7599
Country	:	US
Telephone Number	:	785-864-0633
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 SUNNYSIDE AVE
Second Line	:	2101 HAWORTH HALL
City	:	LAWRENCE
State	:	KS
Zip	:	66045-7600
Country	:	US
Telephone Number	:	785-864-4690
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2007
Last Update Date	:	08/24/2010

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