Provider Demographics
NPI:1366033458
Name:PARCHETA, AMANDA KAYE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:KAYE
Last Name:PARCHETA
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 1:1200 E MICHIGAN AVE STE 415
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-1858
Mailing Address - Country:US
Mailing Address - Phone:517-484-2760
Mailing Address - Fax:
Practice Address - Street 1:1200 E MICHIGAN AVE STE 415
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-1858
Practice Address - Country:US
Practice Address - Phone:517-484-2760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601009988363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant