Provider Demographics
NPI:1902894769
Name:KISH, BARBARA ANN (CFNP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:KISH
Suffix:
Gender:F
Credentials:CFNP
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Mailing Address - Street 1:501 LAPEER AVE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48607-1208
Mailing Address - Country:US
Mailing Address - Phone:989-759-6464
Mailing Address - Fax:989-399-8233
Practice Address - Street 1:1522 JANES AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48601-1819
Practice Address - Country:US
Practice Address - Phone:989-755-0316
Practice Address - Fax:989-755-0956
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704156952363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1902894769Medicaid
MI500G310570OtherBCBS
1010614OtherMCLAREN HEALTH PLAN
500023635OtherRAILROAD MEDICARE
381908328OtherTRICARE
MI100OtherCOMMUNITY CHOICE
1010614OtherHEALTH ADVANTAGE
105431OtherGREAT LAKES HEALTH PLAN
MI2976876OtherMOLINA HEALTH CARE
MI1902894769Medicaid
500023635OtherRAILROAD MEDICARE