Provider Demographics
NPI:1063414290
Name:KAMPS, BARBARA S (CRNA)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:S
Last Name:KAMPS
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 1:560 N SWITZER CANYON DR
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-4844
Mailing Address - Country:US
Mailing Address - Phone:928-774-3044
Mailing Address - Fax:
Practice Address - Street 1:950 W PINON
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401
Practice Address - Country:US
Practice Address - Phone:505-427-1794
Practice Address - Fax:505-327-5355
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1445367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM34683003Medicaid
NM91481Medicaid
AZ914144Medicaid
NM91481Medicaid