Provider Demographics
NPI:1821825498
Name:BARR, ANNA CATHERINE (NP)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:CATHERINE
Last Name:BARR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:CATHERINE
Other - Last Name:SHAFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2401 W UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47303-3428
Practice Address - Country:US
Practice Address - Phone:765-751-5480
Practice Address - Fax:765-281-6567
Is Sole Proprietor?:No
Enumeration Date:2024-09-17
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28257729A163W00000X
IN71015746A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1104501847OtherANTHEM PTAN
IN300097379Medicaid