Provider Demographics
NPI:1245041649
Name:BARNES, ANDREA (NP)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:BARNES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5788 POLAR CIR
Mailing Address - Street 2:
Mailing Address - City:SILVER BAY
Mailing Address - State:MN
Mailing Address - Zip Code:55614-3600
Mailing Address - Country:US
Mailing Address - Phone:204-721-4830
Mailing Address - Fax:
Practice Address - Street 1:1120 WAYZATA BLVD E STE 110
Practice Address - Street 2:
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-1985
Practice Address - Country:US
Practice Address - Phone:952-222-7670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN12443363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care