Basic Information
| Provider Information | |||||||||
| NPI: | 1831591478 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARINGER | ||||||||
| FirstName: | SHANNON | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2101 N WALDRON ST | ||||||||
| Address2: | |||||||||
| City: | HUTCHINSON | ||||||||
| State: | KS | ||||||||
| PostalCode: | 675021131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6206692500 | ||||||||
| FaxNumber: | 6202596803 | ||||||||
| Practice Location | |||||||||
| Address1: | 103 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | CHENEY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 670258844 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3165406190 | ||||||||
| FaxNumber: | 3165406193 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/25/2014 | ||||||||
| LastUpdateDate: | 08/23/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 76516 | KS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 201103810A | 05 | KS | MEDICAID |