Provider Demographics
NPI:1487697454
Name:BARNES, ROBERT M (CRNA)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:M
Last Name:BARNES
Suffix:
Gender:M
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:PO BOX 1375
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32402-1375
Mailing Address - Country:US
Mailing Address - Phone:850-866-3138
Mailing Address - Fax:
Practice Address - Street 1:307 WILSON AVE. SLIP 16
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401
Practice Address - Country:US
Practice Address - Phone:850-866-3138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28101289A367500000X
NMCRNA00777367500000X
GARN067080367500000X
TX560611367500000X
AL1-055700367500000X
ARC01229367500000X
FLAPRN9329731367500000X
CO90872367500000X
FL9329731367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA834607656DMedicaid
GA834607656CMedicaid
GA834607656DMedicaid
MSC02626Medicare ID - Type Unspecified
FLG0111Medicare ID - Type Unspecified