Provider Demographics
NPI:1912973462
Name:BARNES, DORIS A (CRNA)
Entity Type:Individual
Prefix:MS
First Name:DORIS
Middle Name:A
Last Name:BARNES
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 JOHN F KENNEDY RD
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52002-3800
Mailing Address - Country:US
Mailing Address - Phone:563-556-8332
Mailing Address - Fax:563-556-8334
Practice Address - Street 1:1900 JOHN F KENNEDY RD
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52002-3800
Practice Address - Country:US
Practice Address - Phone:563-556-8332
Practice Address - Fax:563-556-8334
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAD-084764367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0084830Medicaid
WI43329800Medicaid
IA0084830Medicaid