Provider Demographics
NPI:1205081064
Name:BARRON, KATHRYN (ANP)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:BARRON
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 457
Mailing Address - Street 2:
Mailing Address - City:GANADO
Mailing Address - State:AZ
Mailing Address - Zip Code:86505-0457
Mailing Address - Country:US
Mailing Address - Phone:928-755-4632
Mailing Address - Fax:928-755-4831
Practice Address - Street 1:US 191 & AZ 264
Practice Address - Street 2:
Practice Address - City:GANADO
Practice Address - State:AZ
Practice Address - Zip Code:86505
Practice Address - Country:US
Practice Address - Phone:928-755-4632
Practice Address - Fax:928-755-4831
Is Sole Proprietor?:No
Enumeration Date:2008-11-20
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN206737363L00000X
MA274083363L00000X
AZAP9997363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner