Provider Demographics
NPI:1073897765
Name:DARLAGE, AMANDA E (PA-C)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:E
Last Name:DARLAGE
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 1:85 MCNAUGHTEN RD
Mailing Address - Street 2:SUITE 200 AND 300
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-2174
Mailing Address - Country:US
Mailing Address - Phone:614-224-2281
Mailing Address - Fax:614-552-0206
Practice Address - Street 1:85 MCNAUGHTEN RD
Practice Address - Street 2:SUITE 200 AND 300
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-2174
Practice Address - Country:US
Practice Address - Phone:614-224-2281
Practice Address - Fax:614-552-0206
Is Sole Proprietor?:No
Enumeration Date:2011-09-29
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.003355363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant