Provider Demographics
NPI:1598705253
Name:BARGER, SHELLEY E (CRNA)
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:E
Last Name:BARGER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4923 FARMSTEAD CT
Mailing Address - Street 2:
Mailing Address - City:BEL AIRE
Mailing Address - State:KS
Mailing Address - Zip Code:67220-1657
Mailing Address - Country:US
Mailing Address - Phone:316-371-4334
Mailing Address - Fax:
Practice Address - Street 1:4923 FARMSTEAD CT
Practice Address - Street 2:
Practice Address - City:BEL AIRE
Practice Address - State:KS
Practice Address - Zip Code:67220-1657
Practice Address - Country:US
Practice Address - Phone:316-371-4334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS55459367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS145227OtherBCBS OF KS
KSP00291366OtherRR MEDICARE GROUP CQ2303
KS200360110AMedicaid
KS145227Medicare PIN
KSP00291366OtherRR MEDICARE GROUP CQ2303