Provider Demographics
NPI:1356338933
Name:BARNES, LETA J (PNP)
Entity type:Individual
Prefix:
First Name:LETA
Middle Name:J
Last Name:BARNES
Suffix:
Gender:
Credentials:PNP
Other - Prefix:
Other - First Name:LETA
Other - Middle Name:J
Other - Last Name:HOHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PNP
Mailing Address - Street 1:3925 W RANDALL ST
Mailing Address - Street 2:
Mailing Address - City:BATTLEFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65619-8303
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3925 W RANDALL ST
Practice Address - Street 2:
Practice Address - City:BATTLEFIELD
Practice Address - State:MO
Practice Address - Zip Code:65619-8303
Practice Address - Country:US
Practice Address - Phone:417-830-7728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO099455363LP0200X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1356338933Medicaid
MO423851211Medicaid
P00361136OtherRR MEDICARE
MO501150017Medicare PIN
MO1356338933Medicaid