Basic Information
| Provider Information | |||||||||
| NPI: | 1760067839 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARNHART | ||||||||
| FirstName: | BRANDON | ||||||||
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| Mailing Information | |||||||||
| Address1: | 240 DUNHAM DR | ||||||||
| Address2: | |||||||||
| City: | WAUKEE | ||||||||
| State: | IA | ||||||||
| PostalCode: | 502638142 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5633493811 | ||||||||
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| Practice Location | |||||||||
| Address1: | 411 LAUREL ST | ||||||||
| Address2: | |||||||||
| City: | DES MOINES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503143017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5152830463 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2021 | ||||||||
| LastUpdateDate: | 03/10/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | D162821 | IA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.