Provider Demographics
NPI:1497078612
Name:BARNES, MANDI L (FNP)
Entity Type:Individual
Prefix:
First Name:MANDI
Middle Name:L
Last Name:BARNES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:MANDI
Other - Middle Name:L
Other - Last Name:WOODS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1600 CHARLES PLACE
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-2750
Mailing Address - Country:US
Mailing Address - Phone:785-539-8900
Mailing Address - Fax:785-539-4425
Practice Address - Street 1:1600 CHARLES PLACE
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:785-539-8900
Practice Address - Fax:785-539-4425
Is Sole Proprietor?:No
Enumeration Date:2010-03-02
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003021283363LF0000X
KS53-76614-091363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1497078612Medicaid
KS201111760AMedicaid
431560263OtherTRICARE WEST
MOP00817791OtherRAILROAD MEDICARE
KS201111760AMedicaid