Provider Demographics
NPI:1285825141
Name:BADURA, DAREN L (MPA)
Entity Type:Individual
Prefix:
First Name:DAREN
Middle Name:L
Last Name:BADURA
Suffix:
Gender:M
Credentials:MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8609 EAGLES LANDING DR
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-1453
Mailing Address - Country:US
Mailing Address - Phone:785-477-1700
Mailing Address - Fax:
Practice Address - Street 1:1600 CHARLES PL
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-2750
Practice Address - Country:US
Practice Address - Phone:785-537-4200
Practice Address - Fax:785-537-4354
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-01208363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS42716OtherBLUE CROSS BLUE SHIELD
KS20441940AMedicaid
KS20441940AMedicaid