Provider Demographics
NPI:1588758569
Name:BARRON, KITTY A (CRNA)
Entity type:Individual
Prefix:
First Name:KITTY
Middle Name:A
Last Name:BARRON
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 1:3801 MORELAND ST
Mailing Address - Street 2:
Mailing Address - City:RUSTON
Mailing Address - State:LA
Mailing Address - Zip Code:71270-8790
Mailing Address - Country:US
Mailing Address - Phone:318-278-2637
Mailing Address - Fax:601-936-0686
Practice Address - Street 1:1275 GLENWOOD DR
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-5539
Practice Address - Country:US
Practice Address - Phone:318-322-1339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP04286367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1197203Medicaid
LA1197203Medicaid