Provider Demographics
NPI:1790679207
Name:BARTRA, KIRSTEN ANNE (NP)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:ANNE
Last Name:BARTRA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3214 JOSHUA AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-6054
Mailing Address - Country:US
Mailing Address - Phone:559-612-3469
Mailing Address - Fax:
Practice Address - Street 1:3214 JOSHUA AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-6054
Practice Address - Country:US
Practice Address - Phone:559-612-3469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-07
Last Update Date:2025-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95035425363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily