Provider Demographics
NPI:1770864217
Name:BARNES, BROOKE ELIZABETH (FNP)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:ELIZABETH
Last Name:BARNES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3651 COLLEGE BLVD STE 100A
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1910
Mailing Address - Country:US
Mailing Address - Phone:913-319-7600
Mailing Address - Fax:913-253-1702
Practice Address - Street 1:3651 COLLEGE BLVD STE 100A
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1910
Practice Address - Country:US
Practice Address - Phone:913-319-7600
Practice Address - Fax:913-253-1702
Is Sole Proprietor?:No
Enumeration Date:2011-08-29
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011032981363LF0000X
KS53-75455-122363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOM3774026Medicare PIN
KSKA2451025Medicare PIN