Provider Demographics
NPI:1275637522
Name:BRIDGES, BARBARA LATINIS (ARNP ED D)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:LATINIS
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:ARNP ED D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6931 CHARLOTTE ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66216-3926
Mailing Address - Country:US
Mailing Address - Phone:913-631-9176
Mailing Address - Fax:
Practice Address - Street 1:10875 GRANDVIEW ST
Practice Address - Street 2:BLDG 22, SUITE 2200
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1510
Practice Address - Country:US
Practice Address - Phone:913-345-0060
Practice Address - Fax:913-345-0090
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2007-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS44482207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P22704Medicare UPIN
KSI31C438Medicare ID - Type Unspecified