Provider Demographics
NPI:1629153846
Name:DE BARROS, JEAN MARIE (PA)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:MARIE
Last Name:DE BARROS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 360
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-0360
Mailing Address - Country:US
Mailing Address - Phone:888-339-6065
Mailing Address - Fax:828-538-4441
Practice Address - Street 1:6051 TYVOLA GLEN CIR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-6431
Practice Address - Country:US
Practice Address - Phone:704-774-6569
Practice Address - Fax:855-308-2340
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2025-11-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-02161363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant