Provider Demographics
NPI:1134463318
Name:BARTON, JARED B (CRNA)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:B
Last Name:BARTON
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8080 E CENTRAL AVE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-2368
Mailing Address - Country:US
Mailing Address - Phone:316-686-7327
Mailing Address - Fax:316-686-1557
Practice Address - Street 1:8080 E CENTRAL AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-2368
Practice Address - Country:US
Practice Address - Phone:316-686-7327
Practice Address - Fax:316-686-1557
Is Sole Proprietor?:No
Enumeration Date:2012-11-12
Last Update Date:2017-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS557146367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100214420AMedicaid
KS100214420AMedicaid