Provider Demographics
NPI:1003055088
Name:BARNETT, TANEISHA LATOYA (PA-C)
Entity Type:Individual
Prefix:MS
First Name:TANEISHA
Middle Name:LATOYA
Last Name:BARNETT
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:2664 COURT DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-1449
Mailing Address - Country:US
Mailing Address - Phone:704-861-9030
Mailing Address - Fax:704-833-1234
Practice Address - Street 1:2664 COURT DR
Practice Address - Street 2:SUITE A
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-1449
Practice Address - Country:US
Practice Address - Phone:704-861-9030
Practice Address - Fax:704-833-1234
Is Sole Proprietor?:No
Enumeration Date:2009-02-13
Last Update Date:2012-05-04
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Provider Licenses
StateLicense IDTaxonomies
NC0010-01441363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical