Provider Demographics
NPI:1356600761
Name:BARNHARD, JASON LEE (CRNA)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:LEE
Last Name:BARNHARD
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 1:172 4TH ST SE
Mailing Address - Street 2:
Mailing Address - City:HURON
Mailing Address - State:SD
Mailing Address - Zip Code:57350-2510
Mailing Address - Country:US
Mailing Address - Phone:605-353-6200
Mailing Address - Fax:605-353-6506
Practice Address - Street 1:172 4TH ST SE
Practice Address - Street 2:
Practice Address - City:HURON
Practice Address - State:SD
Practice Address - Zip Code:57350-2510
Practice Address - Country:US
Practice Address - Phone:605-353-6200
Practice Address - Fax:605-353-6506
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-07
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCR000786367500000X
SDR041264163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse