Provider Demographics
NPI:1508898917
Name:BARNHARDT, DENISE L (PA)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:L
Last Name:BARNHARDT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6525 BARRIE RD
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2305
Mailing Address - Country:US
Mailing Address - Phone:952-915-6000
Mailing Address - Fax:952-915-6100
Practice Address - Street 1:6525 BARRIE RD
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2305
Practice Address - Country:US
Practice Address - Phone:952-915-6000
Practice Address - Fax:952-915-6100
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9462363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical