Provider Demographics
NPI:1639596505
Name:KANESKI, BARBARA I (CNP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:KANESKI
Suffix:I
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:
Other - Last Name:KANESKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:49725 CTY 83
Mailing Address - Street 2:
Mailing Address - City:STAPLES
Mailing Address - State:MN
Mailing Address - Zip Code:56479
Mailing Address - Country:US
Mailing Address - Phone:218-894-1515
Mailing Address - Fax:
Practice Address - Street 1:49725 CTY 83
Practice Address - Street 2:
Practice Address - City:STAPLES
Practice Address - State:MN
Practice Address - Zip Code:56479
Practice Address - Country:US
Practice Address - Phone:218-894-1515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-27
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP02384363LF0000X
MNCNP5191363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily