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Travis John La Barre

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

PECOS Enrollment

This provider is enrolled in PECOS as TRAVIS LA BARRE.

Based on the most recent information from CMS, provider Travis John La Barre is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1598474108
Provider Type
Individual
Full Name
La Barre, Travis John
Credential
NP

Gender
Male
Sole Proprietor
No
Enumeration Date
11/22/2022
Last Updated
11/22/2022

Contact Information

Practice Location

130 2nd St, Neenah, WI 54956-2883

(920) 420-6189

Unlisted Fax

Mailing Location

1631 S Van Dyke Rd, Appleton, WI 54914-8269

(920) 420-6189

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 13282-33 Wisconsin

Travis John La Barre

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Mann, Amanda Mae

Luangla, My See

Barker, Mary Anne

Herkstroeter, Megan Rae

Hoersch, Bonnie B

Williams, Christopher John

Levine, Jane E

Schiesl, Linda L

Klein, Jill N

Piwoni, Stephanie Jean