Provider Demographics
NPI:1245457977
Name:BARTLETT, TRISHA ANN (PA-C)
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:ANN
Last Name:BARTLETT
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 1:1316 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLARION
Mailing Address - State:IA
Mailing Address - Zip Code:50525-2019
Mailing Address - Country:US
Mailing Address - Phone:515-602-9833
Mailing Address - Fax:
Practice Address - Street 1:1924 SUPERIOR ST
Practice Address - Street 2:
Practice Address - City:WEBSTER CITY
Practice Address - State:IA
Practice Address - Zip Code:50595-3146
Practice Address - Country:US
Practice Address - Phone:515-832-3332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001806363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA58750OtherWELLMARK BL/CR BL/SH
IAI20077Medicare PIN