Provider Demographics
NPI:1043972383
Name:BAARS, JEANNETTE DOROTHY (PA-C)
Entity Type:Individual
Prefix:
First Name:JEANNETTE
Middle Name:DOROTHY
Last Name:BAARS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 176
Mailing Address - Street 2:
Mailing Address - City:SAINT REGIS
Mailing Address - State:MT
Mailing Address - Zip Code:59866-0176
Mailing Address - Country:US
Mailing Address - Phone:406-649-7307
Mailing Address - Fax:406-649-7309
Practice Address - Street 1:341 MT HIGHWAY 135
Practice Address - Street 2:
Practice Address - City:SAINT REGIS
Practice Address - State:MT
Practice Address - Zip Code:59866-9767
Practice Address - Country:US
Practice Address - Phone:406-649-7307
Practice Address - Fax:406-649-7309
Is Sole Proprietor?:No
Enumeration Date:2021-10-13
Last Update Date:2022-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMED-PAC-LIC-102189363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical