Provider Demographics
NPI:1407944424
Name:BARNES, AMANDA (CRNA)
Entity Type:Individual
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First Name:AMANDA
Middle Name:
Last Name:BARNES
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Gender:F
Credentials:CRNA
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Mailing Address - Street 1:145 KIMEL PARK DR STE 120
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-6983
Mailing Address - Country:US
Mailing Address - Phone:336-778-7568
Mailing Address - Fax:336-714-6404
Practice Address - Street 1:3333 SILAS CREEK PKWY
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3013
Practice Address - Country:US
Practice Address - Phone:336-718-5181
Practice Address - Fax:336-718-9846
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2023-01-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC132378367500000X
NC001645367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered