Provider Demographics
NPI:1376884759
Name:BARRON, KATHERYNE ANNE (NP)
Entity Type:Individual
Prefix:
First Name:KATHERYNE
Middle Name:ANNE
Last Name:BARRON
Suffix:
Gender:F
Credentials:NP
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Other - Last Name:
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Mailing Address - Street 1:4705 MONTGOMERY BLVD NE
Mailing Address - Street 2:LMG GASTROENTEROLOGY CLINIC 102
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109
Mailing Address - Country:US
Mailing Address - Phone:505-727-7833
Mailing Address - Fax:505-727-6944
Practice Address - Street 1:4705 MONTGOMERY BLVD NE
Practice Address - Street 2:LMG GASTROENTEROLOGY CLINIC 102
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109
Practice Address - Country:US
Practice Address - Phone:505-727-7833
Practice Address - Fax:505-727-6944
Is Sole Proprietor?:No
Enumeration Date:2013-03-08
Last Update Date:2017-01-06
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Provider Licenses
StateLicense IDTaxonomies
TN17304363LF0000X
NMCNP-03012363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ000369Medicaid
TNQ000369Medicaid